Immunogenic compositions for gram positive bacteria such as streptococcus agalactiae

ABSTRACT

The present invention is directed to compounds of Formula I: I (where A 1 , A 2 , B 1 , B 2 , B 3 , B 4 , D 1 , D 2 , T, U, V, W, X, Y, Z. R 4 , R 5a ?, R 5b , R 5c , R 6 , m and n are defined herein) useful as antagonists of CGRP receptors and useful in the treatment or prevention of diseases in which the CGRP is involved, such as headache, migraine and cluster headache. The invention is also directed to pharmaceutical compositions comprising these compounds and the use of these compounds and compositions in the prevention or treatment of such diseases in which CGRP is involved.

BACKGROUND OF THE INVENTION

CGRP (Calcitonin Gene-Related Peptide) is a naturally occurring 37-amino acid peptide that is generated by tissue-specific alternate processing of calcitonin messenger RNA and is widely distributed in the central and peripheral nervous system. CGRP is localized predominantly in sensory afferent and central neurons and mediates several biological actions, including vasodilation. CGRP is expressed in alpha- and beta-forms that vary by one and three amino acids in the rat and human, respectively. CGRP-alpha and CGRP-beta display similar biological properties. When released from the cell, CGRP initiates its biological responses by binding to specific cell surface receptors that are predominantly coupled to the activation of adenylyl cyclase. CGRP receptors have been identified and pharmacologically evaluated in several tissues and cells, including those of brain, cardiovascular, endothelial, and smooth muscle origin.

Based on pharmacological properties, these receptors are divided into at least two subtypes, denoted CGRP₁ and CGRP₂. Human α-CGRP-(8-37), a fragment of CGRP that lacks seven N-terminal amino acid residues, is a selective antagonist of CGRP₁, whereas the linear analogue of CGRP, diacetoamido methyl cysteine CGRP ([Cys(ACM)2,7]CGRP), is a selective agonist of CGRP₂. CGRP is a potent vasodilator that has been implicated in the pathology of cerebrovascular disorders such as migraine and cluster headache. In clinical studies, elevated levels of CGRP in the jugular vein were found to, occur during migraine attacks (Goadsby et al., Ann. Neurol., 1990, 28, 183-187). CGRP activates-receptors on the smooth muscle of intracranial vessels, leading to increased vasodilation, which is thought to be the major source of headache pain during migraine attacks (Lance, Headache Pathogenesis: Monoamines, Neuropeptides, Purines and Nitric Oxide, Lippincott-Raven Publishers, 1997, 3-9). The middle meningeal artery, the principle artery in the dura mater, is innervated by sensory fibers from the trigeminal ganglion which contain several neuropeptides, including CGRP. Trigeminal ganglion stimulation in the cat resulted in increased levels of CGRP, and in humans, activation of the trigeminal system caused facial flushing and increased levels of CGRP in the external jugular vein (Goadsby et al., Ann. Neurol., 1988, 23, 193-196). Electrical stimulation of the dura mater 9 in rats increased the diameter of the middle meningeal artery, an effect that was blocked by prior administration of CGRP(8-37), a peptide CGRP antagonist (Williamson et al., Cephalalgia, 1997, 17, 525-531). Trigeminal ganglion stimulation increased facial blood flow in the rat, which was inhibited by CGRP(8-37) (Escott et al., Brain Res. 1995, 669, 93-99). Electrical stimulation of the trigeminal ganglion in marmoset produced an increase in facial blood flow that could be blocked by the non-peptide CGRP antagonist BIBN4096BS (Doods et al., Br. J. Pharmacol., 2000, 129, 420-423). Thus the vascular effects of CGRP may be attenuated, prevented or reversed by a CGRP antagonist.

CGRP-mediated vasodilation of rat middle meningeal artery was shown to sensitize neurons of the trigeminal nucleus caudalis (Williamson et al., The CGRP Family: Calcitonin Gene-Related Peptide (CGRP), Amylin, and Adrenomedullin, Landes Bioscience, 2000, 245-247). Similarly, distention of dural blood vessels during migraine headache may sensitize trigeminal neurons. Some of the associated symptoms of migraine, including extra-cranial pain and facial allodynia, may be the result of sensitized trigeminal neurons (Burstein et al., Ann. Neurol. 2000, 47, 614-624). A CGRP antagonist may be beneficial in attenuating, preventing or reversing the effects of neuronal sensitization.

The ability of the compounds of the present invention to act as CGRP antagonists makes them useful pharmacological agents for disorders that involve CGRP in humans and animals, but particularly in humans. Such disorders include migraine and cluster headache (Doods, Curr Opin Inves Drugs, 2001, 2 (9), 1261-1268; Edvinsson et al., Cephalalgia, 1994, 14, 320-327); chronic tension type headache (Ashina et al., Neurology, 2000, 14, 1335-1340); pain (Yu et al., Eur. J. Pharm., 1998, 347, 275-282); chronic pain (Hulsebosch et al., Pain, 2000, 86, 163-175); neurogenic inflammation and inflammatory pain (Holzer, Neurosci., 1988, 24, 739-768; Delay-Goyet et al., Acta Physiol. Scanda. 1992, 146, 537-538; Salmon et al., Nature Neurosci., 2001, 4(4), 357-358); eye pain (May et al. Cephalalgia, 2002, 22, 195-196), tooth pain (Awawdeh et al., Int. Endocrin. J., 2002, 35, 30-36), non-insulin dependent diabetes mellitus (Molina et al., Diabetes, 1990, 39, 260-265); vascular disorders; inflammation (Zhang et al., Pain, 2001, 89, 265), arthritis, bronchial hyperreactivity, asthma, (Foster et al., Ann. NY Acad. Sci., 1992, 657, 397-404; Schini et al., Am. J. Physiol., 1994, 267, H2483-H2490; Zheng et al., J. Virol., 1993, 67, 5786-5791); shock, sepsis (Beer et al., Crit. Care Med., 2002, 30 (8), 1794-1798); opiate withdrawal syndrome (Salmon et al., Nature Neurosci., 2001, 4(4), 357-358) morphine tolerance (Menard et al., J. Neurosci., 1996, 16 (7), 2342-2351); hot flashes in men and women (Chen et al., Lancet, 1993, 342, 49; Spetz et al., J. Urology, 2001, 166, 1720-1723); allergic dermatitis (Wallengren, Contact Dermatitis, 2000, 43 (3), 137-143); psoriasis; encephalitis, brain trauma, ischaemia, stroke, epilepsy, and neurodegenerative diseases (Rohrenbeck et al., Neurobiol. of Disease 1999, 6, 15-34); skin diseases (Geppetti and Holzer, Eds., Neurogenic Inflammation, 1996, CRC Press, Boca Raton, Fla.), neurogenic cutaneous redness, skin rosaceousness and erythema; tinnitus (Herzog et al., J. Membrane Biology, 2002, 189(3), 225); inflammatory bowel disease, irritable bowel syndrome, (Hoffman et al. Scandinavian Journal of Gastroenterology, 2002, 37(4) 414-422) and cystitis. Of particular importance is the acute or prophylactic treatment of headache, including migraine and cluster headache.

The present invention relates to compounds that are useful as ligands for CGRP receptors, in particular antagonists for CGRP receptors, processes for their preparation, their use in therapy, pharmaceutical compositions comprising them and methods of therapy using them.

SUMMARY OF THE INVENTION

The present invention is directed to compounds which are antagonists of CGRP receptors and which are useful in the treatment or prevention of diseases in which the CGRP is involved, such as migraine. The invention is also directed to pharmaceutical compositions comprising these compounds and the use of these compounds and compositions in the prevention or treatment of such diseases in which CGRP is involved.

DETAILED DESCRIPTION OF THE INVENTION

The present invention is directed to compounds of the formula I:

wherein: A¹ and A² are each independently selected from:

-   -   (1) a bond,     -   (2) —CR¹³R¹⁴—, wherein R¹³ and R¹⁴ are each independently         selected from: hydrogen, hydroxy, halo, and C₁₋₆ alkyl which is         unsubstituted or substituted with 1-6 fluoro,         where one of A¹ and A² is optionally absent;         B¹ and B⁴ are each independently selected from: ═C—, —C(R¹)—,         and —N—;         B² and B³ are each independently selected from: a bond, ═C(R¹)—,         —CR¹R²—, —C(═O)—, —C(═S)—, ═N—, —N(R¹)—, —O—, —S—, and —SO₂—,         where one of B² and B³ is optionally absent;         D¹ and D² are each independently selected from: ═C(R¹)—;         —CR¹R²—, —C(═O)—, —C(═S)—, ═N—, —N(R¹)—, —O—, —S—, and —SO₂—;         T, U and V are each independently selected from: ═C(R¹)—, and         ═N—, where at least one of T, U, and V is ═C(R¹)—;         W, X, Y, and Z are each independently selected from: a bond,         ═C(R¹)—, —CR¹R²—, —C(═O)—, —C(═S)—, ═N—, —N(R¹)—, —O—, —S—,         —S(O)— and —SO₂—;         R¹ and R² are each independently selected from:     -   (1) hydrogen;     -   (2) —C₁₋₆alkyl which is unsubstituted or substituted with 1-7         substituents each independently selected from:         -   (a) halo,         -   (b) hydroxy,         -   (c) —O—C₁₋₆alkyl,         -   (d) —C₃₋₆cycloalkyl,         -   (e) phenyl or heterocycle, wherein heterocycle is selected             from: azetidinyl, imidazolyl, oxazolyl, pyridyl,             pyrimidinyl, pyrazinyl, pyridazinyl, piperidinyl, azepinyl,             piperazinyl, pyrazolyl, pyrrolidinyl, thiazolyl, thienyl,             triazolyl, tetrazolyl, tetrahydrofuryl and morpholinyl,             which phenyl or heterocycle is unsubstituted or substituted             with 1-5 substituents each independently selected from:             —C₁₋₆alkyl, —O—C₁₋₆alkyl, halo, hydroxy, trifluoromethyl,             —OCF₃, and oxo,         -   (f) —CO₂R⁹, wherein R⁹ is independently selected from:             hydrogen, —C₃₋₆cycloalkyl, benzyl, phenyl, and —C₁₋₆alkyl             which is unsubstituted or substituted with 1-6 fluoro,         -   (g) —NR¹⁰R¹¹, wherein R¹⁰ and R¹¹ are each independently             selected from:             -   hydrogen, —C₅₋₆cycloalkyl, benzyl, phenyl, —COR⁹,                 —SO₂R¹², and —C₁₋₆alkyl which is unsubstituted or                 substituted with 1-6 fluoro,         -   (h) —SO₂R¹²— wherein R¹² is independently selected from:             —C₅₋₆cycloalkyl, benzyl, phenyl, and —C₁₋₆alkyl which is             unsubstituted or substituted with 1-6 fluoro,         -   (i) —CONR^(10a)R^(11a), wherein R^(10a) and R^(11a) are each             independently selected from: hydrogen, —C₅₋₆cycloalkyl,             benzyl, phenyl, and —C₁₋₆alkyl which is unsubstituted or             substituted with 1-6 fluoro,             -   or R^(10a) and R^(11a) are joined to form a ring                 selected from azetidinyl, pyrrolidinyl, piperidinyl,                 piperazinyl, and morpholinyl, which ring is                 unsubstituted or substituted with 1-5 substituents each                 independently selected from: —C₁₋₆alkyl, —O—C₁₋₆alkyl,                 halo, hydroxyl, phenyl and benzyl,         -   (j) trifluoromethyl,         -   (k) —OCO₂R⁹,         -   (l) —(NR^(10a))CO₂R⁹,         -   (m) —O(CO)NR^(10a)R^(l1a),         -   (n) —(NR⁹)(CO)NR^(10a)R^(11a), and         -   (o)—O—C₃₋₆cycloalkyl,     -   (3) —C₃₋₆cycloalkyl, which is unsubstituted or substituted with         1-7 substituents each independently selected from:         -   (a) halo,         -   (b) hydroxy,         -   (c) —O—C₁₋₆alkyl,         -   (d) trifluoromethyl,         -   (e) phenyl which is unsubstituted or substituted with 1-5             substituents independently selected from: —C₁₋₆alkyl,             —O—C₁₋₆alkyl, halo, hydroxy, and trifluoromethyl,     -   (4) phenyl or heterocycle, wherein heterocycle is selected from:         pyridyl, pyrimidinyl, pyrazinyl, thienyl, pyridazinyl,         pyrrolidinyl, azetidinyl, thiazolyl, isothiazolyl, oxazolyl,         isoxazolyl, imidazolyl, triazolyl, tetrazolyl, azepinyl,         benzimidazolyl, benzopyranyl, benzofuryl, benzothiazolyl,         benzoxazolyl, chromanyl, furyl, imidazolinyl, indolinyl,         indolyl, quinolinyl, isoquinolinyl, tetrahydroquinolinyl,         isoindolinyl, tetrahydroisoquinolinyl, 2-oxopiperazinyl,         2-oxopiperidinyl, 2-oxopyrrolidinyl, pyrazolidinyl, pyrazolyl,         pyrrolyl, quinazolinyl, tetrahydrofuryl, thiazolinyl, purinyl,         naphthyridinyl, quinoxalinyl, 1,3-dioxolanyl, oxadiazolyl,         piperidinyl, tetrahydropyranyl, tetrahydrothienyl,         tetrahydrothiopyranyl, and morpholinyl, which phenyl or         heterocycle is unsubstituted or substituted with 1-5         substituents each independently selected from:         -   (a) —C₁₋₆alkyl, which is unsubstituted or substituted with             1-6 fluoro,         -   (b) halo,         -   (c) hydroxy,         -   (d) —O—C₁₋₆alkyl, which is unsubstituted or substituted with             1-6 fluoro,         -   (e) —C₃₋₆cycloalkyl,         -   (f) phenyl or heterocycle, wherein heterocycle is selected             from: pyridyl, pyrimidinyl, pyrazinyl, thienyl and             morpholinyl,             -   which phenyl or heterocycle is unsubstituted or                 substituted with 1-5 substituents each independently                 selected from: —C₁₋₆alkyl, —O—C₁₋₆alkyl, halo, hydroxy                 and trifluoromethyl,         -   (g) —CO₂R⁹,         -   (h) —(CO)R⁹,         -   (i)—NR¹⁰R¹¹,         -   (j) —CONR¹⁰R¹¹,         -   (k) oxo,         -   (l) —SR¹²,         -   (m) —S(O)R¹²,         -   (n) —SO₂R¹², and         -   (o) —CN,     -   (5) halo,     -   (6) oxo,     -   (7) hydroxy,     -   (8) —O—C₁₋₆alkyl, which is unsubstituted or substituted with 1-5         halo;     -   (9) —CN,     -   (10) —CO₂R⁹,     -   (11) —NR¹⁰R¹¹,     -   (12) —SO₂R¹²,     -   (13) —CONR^(10a)R^(11a),     -   (14) —OCO₂R⁹,     -   (15) —(NR^(10a))CO₂R⁹,     -   (16) —O(CO)NR^(10a)R^(11a),     -   (17) —(NR⁹)(CO)NR^(10a)R^(11a),     -   (18) —(CO)—(CO)NR^(10a)R^(11a), and     -   (19) —(CO)—(CO)OR⁹;         R⁴ is selected from: hydrogen, C₅₋₆ cycloalkyl, benzyl, phenyl         and C₁₋₆ alkyl which is unsubstituted or substituted with 1-6         fluoro,         R^(5a), R^(5b) and R^(5c) are each independently selected from:         hydrogen, C₁₋₆ alkyl, —O—C₁₋₆alkyl, —OCF₃, trifluoromethyl,         halo, hydroxy and —CN;         R⁶ is selected from:     -   (1) hydrogen,     -   (2) —C₁₋₆alkyl or —C₃₋₆cycloalkyl, unsubstituted or substituted         with 1-7 substituents independently selected from:         -   (a) halo,         -   (b) hydroxy,         -   (c) —O—C₁₋₆alkyl,         -   (d) —C₃₋₆cycloalkyl,         -   (e) phenyl which is unsubstituted or substituted with 1-5             substituents each independently selected from: —C₁₋₆alkyl,             —O—C₁₋₆alkyl, halo, hydroxy, and trifluoromethyl,         -   (f) —CO₂R⁹,         -   (g) —NR¹⁰R¹¹,         -   (h) —CONR¹⁰R¹¹,         -   (i) —SO₂R¹², and         -   (j) trifluoromethyl     -   (3) phenyl or heterocycle, wherein heterocycle is selected from:         pyridyl, pyrimidinyl, pyrazinyl, thienyl and morpholinyl, which         phenyl or heterocycle is unsubstituted or substituted with 1-5         substituents each independently selected from: —C₁₋₆alkyl,         —O—C₁₋₆alkyl, halo, hydroxy, and trifluoromethyl;         m is 1 or 2;         n is 1 or 2;         and pharmaceutically acceptable salts thereof and individual         enantiomers and diastereomers thereof.

The following examples are presented in order to illustrate some structures that fall within the definition of formula I, but should not be taken as limiting the scope of the invention in any way.

For example, when: A¹ is —CH₂—; A² is a bond; B¹ is —N—; B⁴ is —N—; B² is —C(═O)—; B³ is a bond; D¹ is —CH₂—; D² is —N(Me)—; T is ═C(H)—; U is ═C(Me)—; V is ═C(H)—; W is —C(═O)—; X is a bond; Y is a bond; Z is a bond; R⁴ is hydrogen; R^(5a) is hydrogen; R^(5b) is hydrogen; R^(5c) is hydrogen; R⁶ is methyl; m is 1; and n is 1; the following structure may be obtained:

As another example, when: A¹ is —CH₂—; A² is a bond; B¹ is ═C—; B⁴ is —N—; B² is ═C(H)—; B³ is a bond; D¹ is —CH₂—; D² is —N(H)—; T is ═C(H)—; U is ═C(H)—; V is ═C(H)—; W is —C(═O)—; X is a bond; Y is a bond; Z is a bond; R⁴ is hydrogen; R^(5a) is hydrogen; R^(5b) is hydrogen; R^(5c) is hydrogen; R⁶ is methyl; m is 1; and n is 1; the following structure may be obtained:

As another example, when: A¹ is —CH₂—; A² is a bond; B¹ is —C(H)—; B⁴ is —N—; B² is —CH₂—; B³ is a bond; D¹ is —CH₂—; D² is —N(H)—; T is ═C(H)—; U is ═C(H)—; V is ═C(H)—; W is —C(═O)—; X is a bond; Y is a bond; Z is a bond; R⁴ is hydrogen; R^(5a) is hydrogen; R^(5b) is hydrogen; R^(5c) is hydrogen; R⁶ is methyl; m is 1; and n is 1; the following structure may be obtained:

As another example, when: A¹ is —CH₂—; A² is a bond; B¹ is —N—; B⁴ is —N—; B² is —C(═O)—; B³ is a bond; D¹ is —CH₂—; D² is —N(Me)—; T is ═C(H)—; U is ═C(H)—; V is ═C(H)—; W is —CH₂—; X is —CH₂—; Y is —C(═O)—; Z is a bond; R⁴ is hydrogen; R^(5a) is hydrogen; R^(5b) is hydrogen; R^(5c) is hydrogen; R⁶ is methyl; m is 1; and n is 1; the following structure may be obtained:

An embodiment of the present invention includes compounds of the formula Ia:

wherein A¹, A², B¹, B², B³, B⁴, D¹, D², T, U, V, W, X, Y, Z, R⁴, R⁶, m, and n are defined herein; and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.

Another embodiment of the present invention includes compounds of the formula Ib:

wherein A¹, A², B¹, B², B³, B⁴, D¹, D², T, U, V, W, X, Y, Z, and R⁶ are defined herein; and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.

Another embodiment of the present invention includes compounds of the formula Ic:

wherein B¹, B², B³, B⁴; D¹, D², T, U, V, W, X, Y, and Z are defined herein; and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.

Another embodiment of the present invention includes compounds of the formula Id:

wherein B¹, B², B⁴, D¹, D², T, U, V, W, X, and Y are defined herein; and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.

Another embodiment of the present invention includes compounds of the formula Ie:

wherein B¹, B², B⁴, D¹, D², T, U, V, W, X, and Y are defined herein; and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.

In an embodiment of the present invention A¹ is CH₂.

In an embodiment of the present invention A² is a bond.

In an embodiment of the present invention B¹ is selected from:

═C—, —C(R¹)—, and —N—, where R¹ is defined herein.

In an embodiment of the present invention B¹ is selected from:

═C—, —C(H)—, —C(Me)—, and —N—.

In an embodiment of the present invention B⁴ is selected from:

═C—, —C(H)—, and —N—.

In an embodiment of the present invention B⁴ is —N—.

In an embodiment of the present invention B² is selected from:

═C(R¹)—, —CR¹R²—, and —C(═O)—, where R¹ and R² are defined herein.

In an embodiment of the present invention B² is selected from:

═C(H)—, —CH₂—, and —C(═O)—.

In an embodiment of the present invention B³ is a bond.

In an embodiment of the present invention D¹ is selected from:

—CR¹R²—, and —N(R¹)—, where R¹ and R² are defined herein.

In an embodiment of the present invention D¹ is selected from:

—CH₂— and —N(H)—.

In an embodiment of the present invention D¹ is —CH₂—

In an embodiment of the present invention D² is selected from:

—CR¹R²— and —N(R¹)—, where R¹ and R² are defined herein.

In an embodiment of the present invention D² is selected from:

—CH₂—, —N(H)— and —N(Me)—.

In an embodiment of the present invention D² is —N(H)—.

In an embodiment of the present invention T is selected from:

═C(R¹)— and ═N—, where R¹ is defined herein.

In an embodiment of the present invention T is selected from:

═C(H)—, and ═N—.

In an embodiment of the present invention U is selected from:

═C(R¹)— and ═N—, where R¹ is defined herein.

In an embodiment of the present invention U is selected from:

═C(H)—, ═C(Me)—, and ═N—.

In an embodiment of the present invention V is ═C(H)—.

In an embodiment of the present invention W is selected from:

a bond, —CR¹R²—, and —C(═O)—; where R¹ and R² are defined herein.

In an embodiment of the present invention W is selected from:

a bond, —CH₂— and —C(═O)—.

In an embodiment of the present invention W is —C(═O)—.

In an embodiment of the present invention X is selected from:

a bond, —CR¹R²— and —C(═O)—, where R¹ and R² are defined herein.

In an embodiment of the present invention X is selected from:

a bond, —CH₂— and —C(═O)—.

In an embodiment of the present invention Y is selected from:

a bond, —CR¹R²— and —C(═O)—, where R¹ and R² are defined herein.

In an embodiment of the present invention Y is selected from:

a bond, —CH₂— and —C(═O)—.

In an embodiment of the present invention Z is selected from:

a bond, —CR¹R²—, and —C(═O)—, where R¹ and R² are defined herein.

In an embodiment of the present invention Z is a bond.

In an embodiment of the present invention R¹ and R² are each independently selected from:

-   -   (1) hydrogen;     -   (2) —C₁₋₆alkyl which is unsubstituted or substituted with 1-5         substituents each independently selected from:         -   (a) halo,         -   (b) hydroxy,         -   (c) —O—C₁₋₆alkyl, . . .         -   (d) —C₃₋₆cycloalkyl,         -   (e) phenyl or heterocycle, wherein heterocycle is selected             from: azetidinyl, imidazolyl, oxazolyl, pyridyl,             pyrimidinyl, pyrazinyl, piperidinyl, piperazinyl,             pyrrolidinyl, thiazolyl, thienyl, triazolyl, tetrazolyl,             tetrahydrofuryl and morpholinyl,             -   which phenyl or heterocycle is unsubstituted or                 substituted with 1-3 substituents each independently                 selected from: —C₁₋₄alkyl, —O—C₁₋₄alkyl, halo, hydroxy,                 trifluoromethyl and —OCF₃,         -   (f) —CO₂R⁹, wherein R⁹ is selected from: hydrogen and             —C₁₋₄alkyl,         -   (g) —NR¹⁰R¹¹, wherein R¹⁰ and R¹¹ are each independently             selected from: hydrogen, —COR⁹, —SO₂R¹² and —C₁₋₄alkyl which             is unsubstituted or substituted with 1-3 fluoro,         -   (h) —CONR^(10a)R^(11a), wherein R^(10a) and R^(11a) are each             independently selected from: hydrogen, —C₅₋₆cycloalkyl, and             —C₁₋₄alkyl which is unsubstituted or substituted with 1-3             fluoro,             -   or R^(10a) and R^(11a) are joined to form a ring                 selected from azetidinyl, pyrrolidinyl, piperidinyl,                 piperazinyl and morpholinyl, which ring is unsubstituted                 or substituted with 1-3 substituents each independently                 selected from: —C₁₋₄alkyl, —O—C₁₋₄alkyl, halo and                 hydroxyl, and         -   (i) —(NR^(10a))CO₂R⁹,     -   (3) —C₃₋₆cycloalkyl, which is unsubstituted or substituted with         1-3 substituents each independently selected from: halo, hydroxy         and —O—C₁₋₆alkyl,     -   (4) phenyl or heterocycle, wherein heterocycle is selected from:         pyridyl, pyrimidinyl, pyrazinyl, thienyl, pyrrolidinyl,         azetidinyl, thiazolyl, oxazolyl, isoxazolyl, imidazolyl,         triazolyl, tetrazolyl, benzimidazolyl, benzoxazolyl,         imidazolinyl, indolinyl, indolyl, quinolinyl, isoquinolinyl,         tetrahydroquinolinyl, isoindolinyl, tetrahydroisoquinolinyl,         2-oxopiperazinyl, 2-oxopiperidinyl, 2-oxopyrrolidinyl,         quinazolinyl, tetrahydrofuryl, naphthyridinyl, quinoxalinyl,         1,3-dioxolanyl, oxadiazolyl, piperidinyl, tetrahydropyranyl and         morpholinyl, which phenyl or heterocycle is unsubstituted or         substituted with 1-3 substituents each independently selected         from: halo, hydroxy, —C₃₋₆cycloalkyl, —CO₂R⁹, —NR¹⁰R¹¹,         —CONR¹⁰R¹¹, —C₁₋₄alkyl, which is unsubstituted or substituted         with 1-3 fluoro, and —O—C₁₋₄alkyl, which is unsubstituted or         substituted with 1-6 fluoro,     -   (5) halo,     -   (6) hydroxy,     -   (7) —O—C₁₋₄alkyl which is unsubstituted or substituted with 1-3         halo,     -   (8) —CN,     -   (9) —CO₂R⁹,     -   (10) —NR¹⁰R¹¹,     -   (11) —CONR^(10a)R^(11a), and     -   (12) —(NR^(10a))CO₂R⁹.

In an embodiment of the present invention R¹ and R² are independently selected from:

-   -   (1) hydrogen;     -   (2) —C₁₋₄alkyl, which is unsubstituted or substituted with 1-3         substituents each independently selected from:         -   (a) halo,         -   (b) —O—C₁₋₄alkyl,         -   (c) phenyl or heterocycle, wherein heterocycle is selected             from: azetidinyl, oxazolyl, pyridyl, pyrimidinyl, pyrazinyl,             piperidinyl, piperazinyl, pyrrolidinyl, tetrahydrofuryl and             morpholinyl, which phenyl or heterocycle is unsubstituted or             substituted with 1-3 substituents each independently             selected from: —C₁₋₄alkyl, —O—C₁₋₄alkyl, halo, and hydroxy,         -   (d) —CO₂R⁹, wherein R⁹ is selected from: hydrogen and             —C₁₋₄alkyl,         -   (e) —NR¹⁰R¹¹, wherein R¹⁰ and R¹¹ are each independently             selected from: hydrogen, and —C₁₋₄alkyl, which is             unsubstituted or substituted with 1-3 fluoro,         -   (f) —CONR^(10a)R^(11a), wherein R^(10a) and R^(11a) are each             independently selected from: hydrogen and —C₁₋₄alkyl which             is unsubstituted or substituted with 1-3 fluoro,             -   or R^(10a) and R^(11a) are joined to form a ring                 selected from azetidinyl, pyrrolidinyl, piperidinyl,                 piperazinyl and morpholinyl,     -   (3) —C₃₋₆cycloalkyl,     -   (4) phenyl or heterocycle, wherein heterocycle is selected from:         pyridyl, pyrimidinyl, pyrazinyl, pyrrolidinyl, azetidinyl,         oxazolyl, imidazolyl, 2-oxopiperazinyl, 2-oxopiperidinyl,         2-oxopyrrolidinyl, tetrahydrofuryl, oxadiazolyl, piperidinyl,         and morpholinyl, which phenyl or heterocycle is unsubstituted or         substituted with 1-3 substituents each independently selected         from: halo, hydroxy, —O—C₁₋₄alkyl, —C₃₋₆cycloalkyl, —NR¹⁰R¹¹,         —CONR¹⁰R¹¹, and —C₁₋₄alkyl which is unsubstituted or substituted         with 1-3 fluoro,     -   (5) halo,     -   (6) hydroxy,     -   (7) —O—C₁₋₄alkyl which is unsubstituted or substituted with 1-3         halo,     -   (8) —CN,     -   (9) —CO₂R⁹,     -   (10) —NR¹⁰R¹¹,     -   (11) —CONR^(10a)R^(11a), and     -   (12) —(NR^(10a))CO₂R⁹.

In an embodiment of the present invention R⁴ is selected from: hydrogen and —C₁₋₆alkyl, which is unsubstituted or substituted with fluoro.

In an embodiment of the present invention R⁴ is hydrogen.

In an embodiment of the present invention R^(5a), R^(5b) and R^(5c) are independently selected from hydrogen, C₁₋₁₆alkyl and halo.

In an embodiment of the present invention R^(5a), R^(5b) and R^(5c) are independently selected from hydrogen and halo.

In an embodiment of the present invention R^(5a), R^(5b) and R^(5c) are hydrogen.

In an embodiment of the present invention R⁶ is selected from:

-   -   (1) hydrogen,     -   (2) —C₁₋₄alkyl which is unsubstituted or substituted with 1-5         substituents each independently selected from: halo, hydroxy,         —C₃₋₆cycloalkyl and phenyl, and     -   (3) phenyl or heterocycle, wherein heterocycle is selected from:         pyridyl, pyrimidinyl and pyrazinyl.

In an embodiment of the present invention R⁶ is selected from:

-   -   (1) hydrogen,     -   (2) —C₁₋₄alkyl which is unsubstituted or substituted with 1-3         substituents each independently selected from: halo and phenyl.

In an embodiment of the present invention R⁶ is hydrogen or methyl.

In an embodiment of the present invention R⁶ is methyl.

In an embodiment of the present invention m is 1.

In an embodiment of the present invention n is 1.

In an embodiment of the present invention n is 2.

It is to be understood that where one or more of the above recited structures or substructures recite multiple substituents having the same designation each such variable may be the same or different from each similarly designated variable.

The compounds of the present invention may contain one or more asymmetric centers and can thus occur as racemates and racemic mixtures, single enantiomers, diastereomeric mixtures and individual diastereomers. Additional asymmetric centers may be present depending upon the nature of the various substituents on the molecule. Each such asymmetric center will independently produce two optical isomers and it is intended that all of the possible optical isomers and diastereomers in mixtures and as pure or partially purified compounds are included within the ambit of this invention. The present invention is meant to comprehend all such isomeric forms of these compounds.

Some of the compounds described herein contain olefinic double bonds, and unless specified otherwise, are meant to include both E and Z geometric isomers.

The independent syntheses of these diastereomers or their chromatographic separations may be achieved as known in the art by appropriate modification of the methodology disclosed herein. Their absolute stereochemistry may be determined by the x-ray crystallography of crystalline products or crystalline intermediates which are derivatized, if necessary, with a reagent containing an asymmetric center of known absolute configuration.

If desired, racemic mixtures of the compounds may be separated so that the individual enantiomers are isolated. The separation can be carried out by methods well known in the art, such as the coupling of a racemic mixture of compounds to an enantiomerically pure compound to form a diastereomeric mixture, followed by separation of the individual diastereomers by standard methods, such as fractional crystallization or chromatography. The coupling reaction is often the formation of salts using an enantiomerically pure acid or base. The diasteromeric derivatives may then be converted to the pure enantiomers by cleavage of the added chiral residue. The racemic mixture of the compounds can also be separated directly by chromatographic methods utilizing chiral stationary phases, which methods are well known in the art.

Alternatively, any enantiomer of a compound may be obtained by stereoselective synthesis using optically pure starting materials or reagents of known configuration by methods well known in the art.

As will be appreciated by those of skill in the art, not every substituent or combination of substituents which are said to form rings are capable of forming a ring structure in every circumstance or situation. Moreover, even those substituents capable of ring formation may or may not form a ring structure in every circumstance or situation

Also as appreciated by those of skill in the art, halo or halogen as used herein are intended to include chloro, fluoro, bromo and iodo.

As used herein, “alkyl” is intended to mean linear, branched and cyclic structures having no double or triple bonds. Thus C₁₋₆alkyl is defined to identify the group as having 1, 2, 3, 4, 5 or 6 carbons in a linear or branched arrangement, such that C₁₋₆alkyl specifically includes methyl, ethyl, n-propyl, iso-propyl, n-butyl, iso-butyl, tert-butyl, pentyl and hexyl. “Cycloalkyl” is an alkyl, part or all of which forms a ring of three or more atoms. C₀ or C₀alkyl is defined to identify the presence of a direct covalent bond.

As used herein, “aryl” is intended to mean any stable monocyclic or bicyclic carbon ring of up to 7 members in each ring, wherein at least one ring is aromatic. Examples of such aryl elements include phenyl, napthyl, tetrahydronapthyl, indanyl, or biphenyl.

The phrase “pharmaceutically acceptable” is employed herein to refer to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.

As used herein, “pharmaceutically acceptable salts” refer to derivatives wherein the parent compound is modified by making acid or base salts thereof. Examples of pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as carboxylic acids; and the like. The pharmaceutically acceptable salts include the conventional non-toxic salts or the quaternary ammonium salts of the parent compound formed, for example, from non-toxic inorganic or organic acids. For example, such conventional non-toxic salts include those derived from inorganic acids such as hydrochloric, hydrobromic, sulfuric, sulfamic, phosphoric, nitric and the like; and the salts prepared from organic acids such as acetic, propionic, succinic, glycolic, stearic, lactic, malic, tartaric, citric, ascorbic, pamoic, maleic, hydroxymaleic, phenylacetic, glutamic, benzoic, salicylic, sulfanilic, 2-acetoxybenzoic, fumaric, toluenesulfonic, methanesulfonic, ethane disulfonic, oxalic, isethionic, and the like.

When the compound of the present invention is basic, salts may be prepared from pharmaceutically acceptable non-toxic acids, including inorganic and organic acids. Such acids include acetic, benzenesulfonic, benzoic, camphorsulfonic, citric, ethanesulfonic, fumaric, gluconic, glutamic, hydrobromic, hydrochloric, isethionic, lactic, maleic, malic, mandelic, methanesulfonic, mucic, nitric, pamoic, pantothenic, phosphoric, succinic, sulfuric, tartaric, p-toluenesulfonic acid, and the like. In one aspect of the invention the salts are citric, hydrobromic, hydrochloric, maleic, phosphoric, sulfuric, fumaric, and tartaric acids. It will be understood that, as used herein, references to the compounds of Formula I are meant to also include the pharmaceutically acceptable salts.

Exemplifying the invention is the use of the compounds disclosed in the Examples and herein. Specific compounds within the present invention include a compound which selected from the group consisting of the compounds disclosed in the following Examples and pharmaceutically acceptable salts thereof and individual diastereomers thereof.

The subject compounds are useful in a method of antagonism of CGRP receptors in a patient such as a mammal in need of such antagonism comprising the administration of an effective amount of the compound. The present invention is directed to the use of the compounds disclosed herein as antagonists of CGRP receptors. In addition to primates, especially humans, a variety of other mammals can be treated according to the method of the present invention.

Another embodiment of the present invention is directed to a method for the treatment, control, amelioration, or reduction of risk of a disease or disorder in which the CGRP receptor is involved in a patient that comprises administering to the patient a therapeutically effective amount of a compound that is an antagonist of CGRP receptors.

The present invention is further directed to a method for the manufacture of a medicament for antagonism of CGRP receptors activity in humans and animals comprising combining a compound of the present invention with a pharmaceutical carrier or diluent.

The subject treated in the present methods is generally a mammal, for example a human being, male or female, in whom antagonism of CGRP receptor activity is desired. The term “therapeutically effective amount” means the amount of the subject compound that will elicit the biological or medical response of a tissue, system, animal or human that is being sought by the researcher, veterinarian, medical doctor or other clinician. As used herein, the term “treatment” refers both to the treatment and to the prevention or prophylactic therapy of the mentioned conditions, particularly in a patient who is predisposed to such disease or disorder.

The term “composition” as used herein is intended to encompass a product comprising the specified ingredients in the specified amounts, as well as any product which results, directly or indirectly, from combination of the specified ingredients in the specified amounts. Such term in relation to pharmaceutical composition, is intended to encompass a product comprising the active ingredient(s), and the inert ingredient(s) that make up the carrier, as well as any product which results, directly or indirectly, from combination, complexation or aggregation of any two or more of the ingredients, or from dissociation of one or more of the ingredients, or from other types of reactions or interactions of one or more of the ingredients. Accordingly, the pharmaceutical compositions of the present invention encompass any composition made by admixing a compound of the present invention and a pharmaceutically acceptable carrier. By “pharmaceutically acceptable” it is meant the carrier, diluent or excipient must be compatible with the other ingredients of the formulation and not deleterious to the recipient thereof.

The terms “administration of” and or “administering a” compound should be understood to mean providing a compound of the invention or a prodrug of a compound of the invention to the individual in need of treatment.

The utility of the compounds in accordance with the present invention as antagonists of CGRP receptor activity may be demonstrated by methodology known in the art. Inhibition of the binding of ¹²⁵I-CGRP to receptors and functional antagonism of CGRP receptors were determined as follows:

NATIVE RECEPTOR BINDING ASSAY: The binding of ¹²⁵I-CGRP to receptors in SK-N-MC cell membranes was carried out essentially as described (Edvinsson et al. (2001) Eur. J. Pharmacol. 415, 39-44). Briefly, membranes (25 μg) were incubated in 1 ml of binding buffer [10 mM HEPES, pH 7.4, 5 mM MgCl₂ and 0.2% bovine serum albumin (BSA)] containing 10 pM ¹²⁵I-CGRP andantagonist. After incubation at room temperature for 3 h, the assay was terminated by filtration through GFB glass fibre filter plates (Millipore) that had been blocked with 0.5% polyethyleneimine for 3 h. The filters were washed three times with ice-cold assay buffer, then the plates were air dried. Scintillation fluid (50 μl) was added and the radioactivity was counted on a Topcount (Packard Instrument). Data analysis was carried out by using Prism and the K_(i) was determined by using the Cheng-Prusoff equation (Cheng & Prusoff (1973) Biochem. Pharmacol: 22, 3099-3108).

NATIVE RECEPTOR FUNCTIONAL ASSAY: SK-N-MC cells were grown in minimal essential medium (MEM) supplemented with 10% fetal bovine serum, 2 mM L-glutamine, 0.1 mM non-essential amino acids, 1 mM sodium pyruvate, 100 units/ml penicillin and 100 μg/ml streptomycin at 37° C., 95% humidity, and 5% CO₂. For cAMP assays, cells were plated at 5×10⁵ cells/well in 96-well poly-D-lysine-coated plates (Becton-Dickinson) and cultured for ˜18 h before assay. Cells were washed with phosphate-buffered saline (PBS, Sigma) then pre-incubated with 300 μM isobutylmethylxanthine in serum-free MEM for 30 min at 37° C. Antagonist was added and the cells were incubated for 10 min before the addition of CGRP. The incubation was continued for another 15 min, then the cells were washed with PBS and processed for cAMP determination according to the manufacturer's recommended protocol. Maximal stimulation over basal was defined by using 100 nM CGRP. Dose-response curves were generated by using Prism. Dose-ratios (DR) were calculated and used to construct full Schild plots (Arunlakshana & Schild (1959) Br. J. Pharmacol. 14, 48-58).

RECOMBINANT RECEPTOR: Human CRLR (Genbank accession number L76380) was subcloned into the expression vector pIREShyg2 (BD Biosciences Clontech) as a 5′NheI and 3′ PmeI fragment. Human RAMP1 (Genbank accession number AJ001014) was subcloned into the expression vector pIRESpuro2 (BD Biosciences Clontech) as a 5′NheI and 3′NotI fragment. 293 cells (human embryonic kidney cells; ATCC #CRL-1573) were cultured in DMEM with 4.5 g/L glucose, 1 mM sodium pyruvate and 2 mM glutamine supplemented with 10% fetal bovine serum (FBS), 100 units/mL penicillin and 100 ug/ml streptomycin, and maintained at 37° C. and 95% humidity. Cells were subcultured by treatment with 0.25% trypsin with 0.1% EDTA in HBSS. Stable cell line generation was accomplished by co-transfecting 10 ug of DNA with 30 ug Lipofectamine 2000 (Invitrogen) in 75 cm² flasks. CRLR and RAMP1 expression constructs were co-transfected in equal amounts. Twenty-four hours after transfection the cells were diluted and selective medium (growth medium+300 ug/ml hygromycin and 1 ug/ml puromycin) was added the following day. A clonal cell line was generated by single cell deposition utilizing a FACS Vantage SE (Becton Dickinson). Growth medium was adjusted to 150 ug/ml hygromycin and 0.5 ug/ml puromycin for cell propagation.

RECOMBINANT RECEPTOR BINDING ASSAY: Cells expressing recombinant human CRLR/RAMP1 were washed with PBS and harvested in harvest buffer containing 50 mM HEPES, 1 mM EDTA and Complete protease inhibitors (Roche). The cell suspension was disrupted with a laboratory homogenizer and centrifuged at 48,000 g to isolate membranes. The pellets were resuspended in harvest buffer plus 250 mM sucrose and stored at −70° C. For binding assays, 10 ug of membranes were incubated in 1 ml binding buffer (10 mM HEPES, pH 7.4, 5 mM MgCl₂, and 0.2% BSA) for 3 hours at room temperature containing 10 pM ¹²⁵I-hCGRP (Amersham Biosciences) and antagonist. The assay was terminated by filtration through 96-well GFB glass fiber filter plates (Millipore) that had been blocked with 0.05% polyethyleneimine. The filters were washed 3 times with ice-cold assay buffer (10 mM HEPES, pH 7.4). Scintillation fluid was added and the plates were counted on a Topcount (Packard). Non-specific binding was determined and the data analysis was carried out with the apparent dissociation constant (K_(i)) determined by using a non-linear least squares fitting the bound CPM data to the equation below:

$Y_{\underset{\_}{obsd}} = \frac{\begin{matrix} {{\left( {Y_{\max} - Y_{m\; i\; n}} \right)\left( {{\% \mspace{14mu} I_{\max}} - {\%_{Imin}/100}} \right)} +} \\ {Y_{m\; i\; n} + {\left( {Y_{\max} - Y_{m\; i\; n}} \right)\left( {100 - {\% \mspace{14mu} {I_{\max}/100}}} \right)}} \end{matrix}}{1 + \left( {\lbrack{Drug}\rbrack/{K_{i}\left( {1 + {\lbrack{Radiolabel}\rbrack/K_{d}}} \right)}^{nH}} \right.}$

Where Y is observed CPM bound, Y_(max) is total bound counts, Y min is non specific bound counts, (Y max−Y min) is specific bound counts, % I max is the maximum percent inhibition, % I min is the minimum percent inhibition, radiolabel is the probe, and the K_(d) is the apparent dissociation constant for the radioligand for the receptor as determined by Hot saturation experiments.

RECOMBINANT RECEPTOR FUNCTIONAL ASSAY: Cells were plated in complete growth medium at 85,000 cells/well in 96-well poly-D-lysine coated plates (Corning) and cultured for ˜19 h before assay. Cells were washed with PBS and then incubated with inhibitor for 30 min at 37° C. and 95% humidity in Cellgro Complete Serum-Free/Low-Protein medium (Mediatech, Inc.) with L-glutamine and 1 g/L BSA. Isobutyl-methylxanthine was added to the cells at a concentration of 300 μM and incubated for 30 min at 37° C. Human α-CGRP was added to the cells at a concentration of 0.3 nM and allowed to incubate at 37° C. for 5 min. After α-CGRP stimulation the cells were washed with PBS and processed for cAMP determination utilizing the two-stage assay procedure according to the manufacturer's recommended protocol (cAMP SPA direct screening assay system; RPA 559; Amersham Biosciences). Dose response curves were plotted and IC₅₀ values determined from a 4-parameter logistic fit as defined by the equation y=((a−d)/(1+(x/c)^(b))+d, where y=response, x=dose, a=max response, d=min response, c=inflection point and b=slope.

In particular, the compounds of the following examples had activity as antagonists of the CGRP receptor in the aforementioned assays, generally with a K₁ or IC₅₀ value of less than about 50 μM. Such a result is indicative of the intrinsic activity of the compounds in use as antagonists of CGRP receptors.

The ability of the compounds of the present invention to act as CGRP antagonists makes them useful pharmacological agents for disorders that involve CGRP in humans and animals, but particularly in humans.

The compounds of the present invention have utility in treating, preventing, ameliorating, controlling or reducing the risk of one or more of the following conditions or diseases: headache; migraine; cluster headache; chronic tension type headache; pain; chronic pain; neurogenic inflammation and inflammatory pain; neuropathic pain; eye pain; tooth pain; diabetes; non-insulin dependent diabetes mellitus; vascular disorders; inflammation; arthritis; bronchial hyperreactivity, asthma; shock; sepsis; opiate withdrawal syndrome; morphine tolerance; hot flashes in men and women; allergic dermatitis; psoriasis, encephalitis; brain trauma; epilepsy; neurodegenerative diseases; skin diseases; neurogenic cutaneous redness, skin rosaceousness and erythema; inflammatory bowel disease, irritable bowel syndrome, cystitis; and other conditions that may be treated or prevented by antagonism of CGRP receptors. Of particular importance is the acute or prophylactic treatment of headache, including migraine and cluster headache.

The subject compounds are further useful in a method for the prevention, treatment, control, amelioration, or reduction of risk of the diseases, disorders and conditions noted herein.

The subject compounds are further useful in a method for the prevention, treatment, control, amelioration, or reduction of risk of the aforementioned diseases, disorders and conditions in combination with other agents.

The compounds of the present invention may be used in combination with one or more other drugs in the treatment, prevention, control, amelioration, or reduction of risk of diseases or conditions for which compounds of Formula I or the other drugs may have utility, where the combination of the drugs together are safer or more effective than either drug alone. Such other drug(s) may be administered, by a route and in an amount commonly used therefor, contemporaneously or sequentially with a compound of Formula I. When a compound of Formula I is used contemporaneously with one or more other drugs, a pharmaceutical composition in unit dosage form containing such other drugs and the compound of Formula I is preferred. However, the combination therapy may also include therapies in which the compound of Formula I and one or more other drugs are administered on different overlapping schedules. It is also contemplated that when used in combination with one or more other active ingredients, the compounds of the present invention and the other active ingredients may be used in lower doses than when each is used singly. Accordingly, the pharmaceutical compositions of the present invention include those that contain one or more other active ingredients, in addition to a compound of Formula I.

For example, the present compounds may be used in conjunction with an anti-migraine agent, such as ergotamine and dihydroergotamine, or other serotonin agonists, especially a 5-HT_(IB/ID) agonist, for example sumatriptan, naratriptan, zolmitriptan, eletriptan, almotriptan, frovatriptan, donitriptan, and rizatriptan, a 5-HT_(ID) agonist such as PNU-142633 and a 5-HT_(IF) agonist such as LY334370; a cyclooxygenase inhibitor, such as a selective cyclooxygenase-2 inhibitor, for example rofecoxib, etoricoxib, celecoxib, valdecoxib or paracoxib; a non-steroidal anti-inflammatory agent or a cytokine-suppressing anti-inflammatory agent, for example with a compound such as ibuprofen, ketoprofen, fenoprofen, naproxen, indomethacin, sulindac, meloxicam, piroxicam, tenoxicam, lornoxicam, ketorolac, etodolac, mefenamic acid, meclofenamic acid, flufenamic acid, tolfenamic acid, diclofenac, oxaprozin, apazone, nimesulide, nabumetone, tenidap, etanercept, tolmetin, phenylbutazone, oxyphenbutazone, diflunisal, salsalate, olsalazine or sulfasalazine and the like; or glucocorticoids. Similarly, the instant compounds may be administered with an analgesic such as aspirin, acetaminophen, phenacetin, fentanyl, sufentanil, methadone, acetyl methadol, buprenorphine or morphine.

Additionally, the present compounds may be used in conjunction with an interleukin inhibitor, such as an interleukin-1 inhibitor; an NK-1 receptor antagonist, for example aprepitant; an NMDA antagonist; an NR2B antagonist; a bradykinin-1 receptor antagonist; an adenosine A1 receptor agonist; a sodium channel blocker, for example lamotrigine; an opiate agonist such as levomethadyl acetate or methadyl acetate; a lipoxygenase inhibitor, such as an inhibitor of 5-lipoxygenase; an alpha receptor antagonist, for example indoramin; an alpha receptor agonist; a vanilloid receptor antagonist; a renin inhibitor; a granzyme B inhibitor; a substance P antagonist; an endothelin antagonist; a norepinephrin precursor; anti-anxiety agents such as diazepam, alprazolam, chlordiazepoxide and chlorazepate; serotonin 5HT₂ receptor antagonists; opiod agonists such as codeine, hydrocodone, tramadol, dextropropoxyphene and febtanyl; an mGluR5 agonist, antagonist or potentiator; a GABA A receptor modulator, for example acamprosate calcium; nicotinic antagonists or agonists including nicotine; muscarinic agonists or antagonists; a selective serotonin reuptake inhibitor, for example fluoxetine, paroxetine, sertraline, duloxetine, escitalopram, or citalopram; an antidepressant, for example amitriptyline, nortriptyline, clomipramine, imipramine, venlafaxine, doxepin, protriptyline, desipramine, trimipramine, or imipramine; a leukotriene antagonist, for example montelukast or zafirlukast; an inhibitor of nitric oxide or an inhibitor of the synthesis of nitric oxide.

Also, the present compounds may be used in conjunction with gap junction inhibitors; neuronal calcium channel blockers such as civamide; AMPA/KA antagonists such as LY293558; sigma receptor agonists; and vitamin B2.

Also, the present compounds may be used in conjunction with ergot alkaloids other than ergotamine and dihydroergotamine, for example ergonovine, ergonovine, methylergonovine, metergoline, ergoloid mesylates, dihydroergocornine, dihydroergocristine, dihydroergocryptine, dihydro-α-ergocryptine, dihydro-β-ergocryptine, ergotoxine, ergocornine, ergocristine, ergocryptine, α-ergocryptine, β-ergocryptine, ergosine, ergostane, bromocriptine, or methysergide.

Additionally, the present compounds may be used in conjunction with a beta-adrenergic antagonist such as timolol, propanolol, atenolol, metoprolol or nadolol, and the like; a MAO inhibitor, for example phenelzine; a calcium channel blocker, for example flunarizine, diltiazem, amlodipine, felodipine, nisolipine, isradipine, nimodipine, lomerizine, verapamil, nifedipine, or prochlorperazine; neuroleptics such as olanzapine, droperidol, prochlorperazine, chlorpromazine and quetiapine; an anticonvulsant such as topiramate, zonisamide, tonabersat, carabersat, levetiracetam, lamotrigine, tiagabine, gabapentin, pregabalin or divalproex sodium; an anti-hypertensive such as an angidtensin II antagonist, for example losartan, irbesartin, valsartan, eprosartan, telmisartan, olmesartan, medoxomil, candesartan and candesartan cilexetil, an angiotensin I antagonist, an angiotensin converting enzyme inhibitor such as lisinopril, enalapril, captopril, benazepril, quinapril, perindopril, ramipril and trandolapril; or botulinum toxin type A or B.

The present compounds may be used in conjunction with a potentiator such as caffeine, an H2-antagonist, simethicone, aluminum or magnesium hydroxide; a decongestant such as oxymetazoline, epinephrine, naphazoline, xylometazoline, propylhexedrine, or levo-desoxy-ephedrine; an antitussive such as caramiphen, carbetapentane, or dextromethorphan; a diuretic; a prokinetic agent such as metoclopramide or domperidone; a sedating or non-sedating antihistamine such as acrivastine, azatadine, bromodiphenhydramine, brompheniramine, carbinoxamine, chlorpheniramine, clemastine, dexbrompheniramine, dexchlorpheniramine, diphenhydramine, doxylamine, loratadine, phenindamine, pheniramine, phenyltoloxamine, promethazine, pyrilamine, terfenadine, triprolidine, phenylephrine, phenylpropanolamine, or pseudoephedrine. The present compounds also may be used in conjunction with anti-emetics.

In a particularly preferred embodiment the present compounds are used in conjunction with an anti-migraine agent, such as: ergotamine or dihydroergotamine; a 5-HT_(I) agonist, especially a 5-HT_(IB/ID) agonist, in particular, sumatriptan, naratriptan, zolmitriptan, eletriptan, almotriptan, frovatriptan, donitriptan, avitriptan and rizatriptan, and other serotonin agonists; and a cyclooxygenase inhibitor, such as a selective cyclooxygenase-2 inhibitor, in particular, rofecoxib, etoricoxib, celecoxib, valdecoxib or paracoxib.

The above combinations include combinations of a compound of the present invention not only with one other active compound, but also with two or more other active compounds. Likewise, compounds of the present invention may be used in combination with other drugs that are used in the prevention, treatment, control, amelioration, or reduction of risk of the diseases or conditions for which compounds of the present invention are useful. Such other drugs may be administered, by a route and in an amount commonly used therefore, contemporaneously or sequentially with a compound of the present invention. When a compound of the present invention is used contemporaneously with one or more other drugs, a pharmaceutical composition containing such other drugs in addition to the compound of the present invention is preferred. Accordingly, the pharmaceutical compositions of the present invention include those that also contain one or more other active ingredients, in addition to a compound of the present invention.

The weight ratio of the compound of the compound of the present invention to the other active ingredient(s) may be varied and will depend upon the effective dose of each ingredient. Generally, an effective dose of each will be used. Thus, for example, when a compound of the present invention is combined with another agent, the weight ratio of the compound of the present invention to the other agent will generally range from about 1000:1 to about 1:1000, or from about 200:1 to about 1:200. Combinations of a compound of the present invention and other active ingredients will generally also be within the aforementioned range, but in each case, an effective dose of each active ingredient should be used.

In such combinations the compound of the present invention and other active agents may be administered separately or in conjunction. In addition, the administration of one element may be prior to, concurrent to, or subsequent to the administration of other agent(s), and via the same or different routes of administration.

The compounds of the present invention may be administered by oral, parenteral (e.g., intramuscular, intraperitoneal, intravenous, ICV, intracisternal injection or infusion, subcutaneous injection, or implant), by inhalation spray, nasal, vaginal, rectal, sublingual, or topical routes of administration and may be formulated, alone or together, in suitable dosage unit formulations containing conventional non-toxic pharmaceutically acceptable carriers, adjuvants and vehicles appropriate for each route of administration. In addition to the treatment of warm-blooded animals the compounds of the invention are effective for use in humans.

The pharmaceutical compositions for the administration of the compounds of this invention may conveniently be presented in dosage unit form and may be prepared by any of the methods well known in the art of pharmacy. All methods include the step of bringing the active ingredient into association with the carrier which constitutes one or more accessory ingredients. In general, the pharmaceutical compositions are prepared by uniformly and intimately bringing the active ingredient into association with a liquid carrier or a finely divided solid carrier or both, and then, if necessary, shaping the product into the desired formulation. In the pharmaceutical composition the active compound is included in an amount sufficient to produce the desired effect upon the process or condition of diseases. As used herein, the term “composition” is intended to encompass a product comprising the specified ingredients in the specified amounts, as well as any product which results, directly or indirectly, from combination of the specified ingredients in the specified amounts.

The pharmaceutical compositions containing the active ingredient may be in a form suitable for oral use, for example, as tablets, troches, lozenges, aqueous or oily suspensions, dispersible powders or granules, emulsions, solutions, hard or soft capsules, or syrups or elixirs. Compositions intended for oral use may be prepared according to any method known to the art for the manufacture of pharmaceutical compositions and such compositions may contain one or more agents selected from the group consisting of sweetening agents, flavoring agents, coloring agents and preserving agents in order to provide pharmaceutically elegant and palatable preparations. Tablets contain the active ingredient in admixture with non-toxic pharmaceutically acceptable excipients which are suitable for the manufacture of tablets. These excipients may be for example, inert diluents, such as calcium carbonate, sodium carbonate, lactose, calcium phosphate or sodium phosphate; granulating and disintegrating agents, for example, corn starch, or alginic acid; binding agents, for example starch, gelatin or acacia; and lubricating agents, for example magnesium stearate, stearic acid or talc. The tablets may be uncoated or they may be coated by known techniques to delay disintegration and absorption in the gastrointestinal tract and thereby provide a sustained action over a longer period. For example, a time delay material such as glyceryl monostearate or glyceryl distearate may be employed. They may also be coated by the techniques described in the U.S. Pat. Nos. 4,256,108; 4,166,452; and 4,265,874 to form osmotic therapeutic tablets for control release. Oral tablets may also be formulated for immediate release, such as fast melt tablets or wafers, rapid dissolve tablets or fast dissolve films.

Formulations for oral use may also be presented as hard gelatin capsules wherein the active ingredient is mixed with an inert solid diluent, for example, calcium carbonate, calcium phosphate or kaolin, or as soft gelatin capsules wherein the active ingredient is mixed with water or an oil medium, for example peanut oil, liquid paraffin, or olive oil.

Aqueous suspensions contain the active materials in admixture with excipients suitable for the manufacture of aqueous suspensions. Such excipients are suspending agents, for example sodium carboxymethylcellulose, methylcellulose, hydroxy-propylmethylcellulose, sodium alginate, polyvinyl-pyrrolidone, gum tragacanth and gum acacia; dispersing or wetting agents may be a naturally-occurring phosphatide, for example lecithin, or condensation products of an alkylene oxide with fatty acids, for example polyoxyethylene stearate, or condensation products of ethylene oxide with long chain aliphatic alcohols, for example heptadecaethyleneoxycetanol, or condensation products of ethylene oxide with partial esters derived from fatty acids and a hexitol such as polyoxyethylene sorbitol monooleate, or condensation products of ethylene oxide with partial esters derived from fatty acids and hexitol anhydrides, for example polyethylene sorbitan monooleate. The aqueous suspensions may also contain one or more preservatives, for example ethyl, or n-propyl, p-hydroxybenzoate, one or more coloring agents, one or more flavoring agents, and one or more sweetening agents, such as sucrose or saccharin.

Oily suspensions may be formulated by suspending the active ingredient in a vegetable oil, for example arachis oil, olive oil, sesame oil or coconut oil, or in a mineral oil such as liquid paraffin. The oily suspensions may contain a thickening agent, for example beeswax, hard paraffin or cetyl alcohol. Sweetening agents such as those set forth above, and flavoring agents may be added to provide a palatable oral preparation. These compositions may be preserved by the addition of an anti-oxidant such as ascorbic acid.

Dispersible powders and granules suitable for preparation of an aqueous suspension by the addition of water provide the active ingredient in admixture with a dispersing or wetting agent, suspending agent and one or more preservatives. Suitable dispersing or wetting agents and suspending agents are exemplified by those already mentioned above. Additional excipients, for example sweetening, flavoring and coloring agents, may also be present.

The pharmaceutical compositions of the invention may also be in the form of oil-in-water emulsions. The oily phase may be a vegetable oil, for example olive oil or arachis oil, or a mineral oil, for example liquid paraffin or mixtures of these. Suitable emulsifying agents may be naturally-occurring gums, for example gum acacia or gum tragacanth, naturally-occurring phosphatides, for example soy bean, lecithin, and esters or partial esters derived from fatty acids and hexitol anhydrides, for example sorbitan monooleate, and condensation products of the said partial esters with ethylene oxide, for example polyoxyethylene sorbitan monooleate. The emulsions may also contain sweetening and flavoring agents.

Syrups and elixirs may be formulated with sweetening agents, for example glycerol, propylene glycol, sorbitol or sucrose. Such formulations may also contain a demulcent, a preservative and flavoring and coloring agents.

The pharmaceutical compositions may be in the form of a sterile injectable aqueous or oleagenous suspension. This suspension may be formulated according to the known art using those suitable dispersing or wetting agents and suspending agents which have been mentioned above. The sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenterally-acceptable diluent or solvent, for example as a solution in 1,3-butane diol. Among the acceptable vehicles and solvents that may be employed are water, Ringer's solution and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium. For this purpose any bland fixed oil may be employed including synthetic mono- or diglycerides. In addition, fatty acids such as oleic acid find use in the preparation of injectables.

The compounds of the present invention may also be administered in the form of suppositories for rectal administration of the drug. These compositions can be prepared by mixing the drug with a suitable non-irritating excipient which is solid at ordinary temperatures but liquid at the rectal temperature and will therefore melt in the rectum to release the drug. Such materials are cocoa butter and polyethylene glycols.

For topical use, creams, ointments, jellies, solutions or suspensions, etc., containing the compounds of the present invention are employed. Similarly, transdermal patches may also be used for topical administration.

The pharmaceutical composition and method of the present invention may further comprise other therapeutically active compounds as noted herein which are usually applied in the treatment of the above mentioned pathological conditions.

In the treatment, prevention, control, amelioration, or reduction of risk of conditions which require antagonism of CGRP receptor activity an appropriate dosage level will generally be about 0.01 to 500 mg per kg patient body weight per day which can be administered in single or multiple doses. A suitable dosage level may be about 0.01 to 250 mg/kg per day, about 0.05 to 100 mg/kg per day, or about 0.1 to 50 mg/kg per day. Within this range the dosage may be 0.05 to 0.5, 0.5 to 5 or 5 to 50 mg/kg per day. For oral administration, the compositions are may be provided in the form of tablets containing 1.0 to 1000 milligrams of the active ingredient, particularly 1.0, 5.0, 10.0, 15.0. 20.0, 25.0, 50.0, 75.0, 100.0, 150.0, 200.0, 250.0, 300.0, 400.0, 500.0, 600.0, 750.0, 800.0, 900.0, and 1000.0 milligrams of the active ingredient for the symptomatic adjustment of the dosage to the patient to be treated. The compounds may be administered on a regimen of 1 to 4 times per day, or may be administered once or twice per day.

When treating, preventing, controlling, ameliorating, or reducing the risk of headache, migraine, cluster headache, or other diseases for which compounds of the present invention are indicated, generally satisfactory results are obtained when the compounds of the present invention are administered at a daily dosage of from about 0.1 milligram to about 100 milligram per kilogram of animal body weight, given as a single daily dose or in divided doses two to six times a day, or in sustained release form. For most large mammals, the total daily dosage is from about 1.0 milligrams to about 1000 milligrams, or from about 1 milligrams to about 50 milligrams. In the case of a 70 kg adult human, the total daily dose will generally be from about 7 milligrams to about 350 milligrams. This dosage regimen may be adjusted to provide the optimal therapeutic response.

It will be understood, however, that the specific dose level and frequency of dosage for any particular patient may be varied and will depend upon a variety of factors including the activity of the specific compound employed, the metabolic stability and length of action of that compound, the age, body weight, general health, sex, diet, mode and time of administration, rate of excretion, drug combination, the severity of the particular condition, and the host undergoing therapy.

Several methods for preparing the compounds of this invention are illustrated in the following Schemes and Examples. Starting materials are made according to procedures known in the art or as illustrated herein.

The compounds of the present invention can be prepared readily according to the following Schemes and specific examples, or modifications thereof, using readily available starting materials, reagents and conventional synthesis procedures. In these reactions, it is also possible to make use of variants which are themselves known to those of ordinary skill in this art but are not mentioned in greater detail. The general procedures for making the compounds claimed in this invention can be readily understood and appreciated by one skilled in the art from viewing the following Schemes.

The synthesis of spirohydantoin intermediates may be conducted as described in Schemes 14. Spirohydantoin intermediates bearing R^(5a), R^(5b) and R^(5c) may be prepared by employing appropriately substituted starting materials or by derivatization of any intermediates and/or final products as desired by methods known in the art.

Commercially available 6-bromo-2-tetralone (1) may be readily converted to the spirohydantoin 2 under Bucherer-Bergs conditions, using ammonium carbonate and either sodium cyanide or potassium cyanide. Other 2-tetralones may be readily accessed using a variety of literature methods, such as the Friedel-Crafts reaction of arylacetyl chlorides with ethene as described by Burckhalter and Campbell (J. Org. Chem. 1961, 26, 4232) and converted to the corresponding spirohydantoins analogously. In Scheme 1, treatment of spirohydantoin 2 with ethyl magnesium bromide followed by tert-butyllithium effects metal-halogen exchange and the resulting aryllithium species is quenched with carbon dioxide to give acid 3. A Schmidt reaction of 3 with hydrazoic acid may be used to provide aniline 4, as reviewed by Wolff (Org. React. 1946, 3, 307). Alternatively, a modified Curtius rearrangement using 3 and diphenylphosphoryl azide according to the procedure of Yamada and coworkers (Tetrahedron 1974, 30, 2151) can provide aniline 4 via either its tert-butyl or benzyl carbamate derivatives.

In Scheme 2, treatment of 6-bromo-2-tetralone (1) with methylamine hydrochloride and potassium cyanide, followed by potassium cyanate and hydrochloric acid, provides the methylated hydantoin derivative 5. Analogous procedures to those described in Scheme 1 may be used to provide acid 6 and aniline 7.

Scheme 3 illustrates a route to 7-substituted tetralin derivatives 10 and 11. 3-Brombphenylacetic acid is converted to the corresponding acid chloride and this is subjected to Friedel-Crafts reaction with ethene, affording the 7-bromo-2-tetralone 9. This intermediate may be elaborated using the procedures described in Scheme 1 to provide the acid (10) and aniline (11).

Scheme 4 details the synthesis of the key indane-based spirohydantoin intermediates.

2-Indanone (12) is converted to the spirohydantoin 13 via Bucherer-Bergs chemistry as shown. Treatment of 13 with nitric acid provides the 5-nitroindane derivative 14, which may be reduced to the corresponding aniline 15 under catalytic hydrogenation conditions. Alternatively, a two-step process can be employed to convert 2-indanone (12) into the N-methylspirohydantoin 16. Treatment of 12 with potassium cyanide and methylamine hydrochloride affords an amino nitrile which is converted to the spirohydantoin 16 using potassium cyanate and acetic acid. Subjection of 16 to the nitration-reduction sequence used for 13 leads to the corresponding aniline 18, as detailed in Scheme 4.

Spirohydantoin intermediates may be resolved to give pure enantiomers using techniques familiar to those skilled in the art. For example, chromatography of the nitro intermediate 17 on a ChiralPak AD column can be used to provide the individual enantiomers (+)-17 and (−)-17, and these enantiomers may be reduced to the corresponding anilines [(+)-18 and (−)-18] by catalytic hydrogenation. Use of standard coupling procedures using enantiomerically pure anilines affords the individual enantiomers of the final products. Resolution may be effected by other methodologies, such as fractional crystallization of diastereomeric salts, and it may be carried out on other synthetic intermediates or on the final products. Alternatively, an asymmetric synthesis of a key intermediate, such as an amino acid precursor of a spirohydantoin, could be used to provide an enantiomerically enriched final product.

Spirohydantoin compounds containing R⁶ substituents other than hydrogen or methyl may be prepared by methods analogous to those for the cases where R⁶ is methyl in Scheme 2 and Scheme 4. Alternatively, a suitably protected spirohydantoin intermediate may be derivatized as shown in Scheme 5.

The route illustrated in Scheme 5 uses a Mitsunobu reaction to selectively protect the imide nitrogen of spirohydantoin 14 with, for example, X=4-methoxyphenyl. Other alkylation conditions may also be employed in this protection step. The protected spirohydantoin 19 may be alkylated with a variety of R⁶ groups using sodium hydride or another base to deprotonate the spirohydantoin. In the example shown, the bromide R⁶Br is utilized to effect the alkylation, but a variety of other R⁶ derivatives, such as chlorides or sulfonates may be used. Other conditions, such as copper or palladium promoted arylation or heteroarylation reactions may also be employed to install aryl or heteroaryl R⁶ groups. The spirohydantoin product 20 is then deprotected to give 21. In Scheme 5, ammonium cerium (TV) nitrate is used to remove the 4-methoxybenzyl protecting group but the choice of deprotection conditions may vary depending on the nature of X. Finally, hydrogenation conditions may be used to provide intermediate 22, in analogy with the previous Schemes.

Spirohydantoin aniline intermediates, such as those described in Schemes 1-5, may be coupled with a variety of carboxylic acids, or carboxylic acid derivatives, to provide amide final products.

Thus, coupling of amine A with a carboxylic acid, R′CO₂H, can be used to give amide B. Other standard coupling conditions may be employed in the synthesis of such amides, such as use of an alternative coupling reagent like PyBOP, or activation of the carboxylic acid as an acid anhydride or acid chloride. Ureas may also be synthesized from aniline A and an appropriate amine by use of phosgene, 1,1′-carbonyldiimidazole, 4-nitrophenyl chloroformate, or a similar reagent.

Most of the acids (R′CO₂H), used to make the compounds of the present invention are readily available. They may be obtained from commercial sources or synthesized by methodology familiar to those skilled in the art and as described in the chemical literature. A number of the acids were synthesized using the methodology outlined in Schemes 7-12.

Scheme 7 illustrates a general route to substituted benzimidazolone tricyclic carboxylic acid I. Starting with the appropriately substituted 3-nitro-1,2-phenylenediamine starting material C, which may be obtained from a variety of published routes and known methodologies (Leibigs Ann. Chem. 1989, 539-544; J Med. Chem. 1995, 38, 4367-4379), the nitrobenzimidazolone D may be synthesized by treatment with phosgene or one of a number of carbonylation reagents, including carbonyldiimidazole and urea. Alternatively, a substituted benzimidazolone may be nitrated in order to provide D (J. Org. Chem. 1995, 60, 1565-1582).

Alkylation of the nitrobenzimidazolone D under basic conditions with a suitable bromoacetate, such as tert-butyl bromoacetate, can afford the monoacetyl derivative E. Further alkylation of the benzimidazolone is accomplished using, for example, sodium hydride as base followed by a suitable bromide to give the benzimidazolone F. In the example shown, bromo esters with different chain lengths may be used to provide a number of different products. In some cases, depending upon the selection of R¹, these alyltations may result in mixtures of regioisomers, and the mixtures of E or F can be separated by chromatography. Reduction of the nitro compound F to the corresponding aniline may be accomplished via a number of standard methods, such as catalytic hydrogenation, and the aniline may be cyclized to give anilide G under acidic conditions. In Scheme 7, the resultant anilide is N-alkylated to give H. For example, when R¹X is iodomethane, the N-methyl analogue is obtained. Alternatively, the anilide nitrogen may be arylated using well-precedented methodology, such as treatment with an aryl bromide and a copper or palladium catalyst (Org. Lett. 2000, 2, 1101-1104; J. Am. Chem. Soc. 2001, 123, 7727-7729). Hydrolysis of the ester to reveal the acid functionality in I can be accomplished using either acidic or basic conditions, depending upon the nature of the ester intermediate H. In Scheme 7, the tert-butyl ester is removed using trifluoroacetic acid.

The phenylenediamine starting material C in Scheme 7 may be prepared in a number of ways. For example, in Scheme 8 the 3-nitro-4-substituted phenylenediamine M is prepared by the initial formation of the selenazole K from the 4-substituted 1,2-phenylenediamine J (J. Med. Chem. 1995, 38, 4367-4379). The selenazole undergoes nitration selectively at the 3-position with standard reagents, such as a combination of nitric and sulfuric acid, to give L. Removal of the selenazole using a mixture of hydroiodic and hydrochloric acid yields the phenylene diamines, which may be used as starting materials in the synthesis of tricyclic carboxylic acids I.

A representative synthesis of an azabenzimidazolone intermediate is illustrated in Scheme 9. Nitration of 4-amino-2,6-dichloropyridine (N) is accomplished by treatment with a mixture of nitric acid and sulfuric acid mixture followed by heating in sulfuric acid (J. Het. Chem. 1965, 2, 196). The nitroaniline O is reduced to the 1,2-diamine P, using Raney nickel in order to leave the chloro substituents intact. The benzimidazolone Q is formed by treatment of P with a urea melt at 165° C., and Q can be bis-alkylated using cesium carbonate and a bromoacetate in order to provide the diester S. Simultaneous removal of the aryl chloro substituents and reduction of the nitro group can be achieved by hydrogenation over a palladium catalyst. The synthesis is completed by cyclization of the resulting aminopyridine under acidic, conditions, followed by saponification of the methyl ester moiety in order to provide the acid T. Using chemical procedures outlined previously and familiar to those skilled in the art, the chemistry in Scheme 9 may be modified in a number of ways in order to provide isomeric azabenzimidazolone intermediates. For example, when 1,3-dihydro-2H-imidazo[4,5-c]pyridin-2-one is reacted with nitric acid, the major product is 4-nitro-1,3-dihydro-2H-imidazo[4,5-c]pyridin-2-one, which may be chemically modified in the same fashion as R-T above to give another regioisomer of the azabenzimidazolone T.

Scheme 10 illustrates a general route to substituted indole tricyclic derivative BB. The nitroindole U can be converted to the nitrile W via a two-step sequence: a Mannich reaction with N,N,N′,N′-tetramethyldiaminomethane followed by treatment with potassium cyanide. Alternatively, the dimethylamine derivative V can be formed by reaction of the nitroindole U with dimethylamine and formaldehyde in a microwave reactor. N-alkylation of W can be accomplished by treatment with an appropriate alkylating agent under basic conditions to give esters of the general form X. Treatment of X with excess sodium hydroxide may be used to hydrolyze both the nitrile and ester groups, to afford the diacid Y. Subjection of this diacid to classical esterification using EtOH and H₂SO₄ converts it to the corresponding diester Z. The nitro moiety may be reduced under a variety of conditions, such as catalytic hydrogenation, and the resulting aniline can be heated under acidic conditions to afford the tricyclic indole AA. Saponification of the ester is thereafter accomplished under standard conditions to provide the acid intermediate BB.

The preparation of substituted indoline tricyclic derivatives is outlined in Scheme 11. Acylation of nitroindole T using Vilsmeier methodology yields the 3-substituted indole CC. Simultaneous reduction of the ketone and the indole may be accomplished using triethylsilane under acidic conditions to afford the indoline DD. N-Alkylation of DD can be achieved by treatment with excess ethyl bromoacetate in the presence of potassium carbonate and potassium iodide to give the ester EE. Further elaboration of EE may be carried out in analogy with previous schemes to provide the indoline acid intermediate HH.

Methodology for the synthesis of indole tricyclic derivatives of the type OO is shown in Scheme 12. The N-protected bromoindole JJ is subjected to a palladium-catalyzed coupling reaction (J. Am. Chem. Soc. 2002, 124, 12557-12565) to afford the substituted indole KK. Nitration at the 3-position of the indole is accomplished by treatment with nitric acid in acetic anhydride. The sulfonamide protective group is removed from the indole and a similar alkylation methodology to that described in previous schemes is employed to yield the diester NN. Reduction of the nitro group and cyclization is accomplished in one pot using iron in acetic acid to provide OO, which may be saponified under standard conditions to provide the acid intermediate of interest.

Simple modifications of these routes, including different protecting group strategies, application of well-precedented methodology, and the use of starting materials and reagents other than those described in the foregoing schemes, may be used to provide other acids of interest, such as those detailed in Intermediates 21-27 (vide infra).

In some cases the order of carrying out the foregoing reaction schemes may be varied to facilitate the reaction or to avoid unwanted reaction products. The following examples are provided so that the invention might be more fully understood. These examples are illustrative only and should not be construed as limiting the invention in any way.

(±)-6′-Carboxy-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione Step A. (±)-6′-Bromo-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione

A stirred mixture of 6-bromo-2-tetralone (17.6 g, 78.2 mmol), sodium cyanide (9.58 g, 195 mmol), and ammonium carbonate (97.7 g, 1.02 mol) in H₂O (100 mL) and EtOH (100 mL) was heated to 70° C. for 3 h, then allowed to cool to ambient temperature. The precipitate was collected by filtration and washed with H₂O (5×200 mL). Drying in vacuo afforded the title compound as a pale solid. MS: m/z=297 (M+1).

Step B. (±)-6′-Carboxy-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione

To a stirred suspension of (±)-6′-bromo-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione (14.9 g, 50.5 mmol) in THF (1.2 L), at −70° C., was added dropwise ethyl magnesium bromide (3.0 M in THF, 51 mL, 152 mmol). The resulting mixture was stirred for 10 min, then tert-butyllithium (1.7 M in pentane, 180 mL, 305 mmol) was added dropwise over 30 min. Stirring was continued at −70° C. for 20 min, then additional tert-butyllithium (1.7 M in pentane, 60 mL, 102 mmol) was added dropwise over 10 min. After a further 30 min, CO₂ (g) was bubbled into the reaction mixture until LCMS analysis indicated complete reaction. The mixture was allowed to warm slowly to ambient temperature and the THF was removed in vacuo. The residue was suspended in H₂O and the solution was adjusted to pH=1-2 by the addition of conc. hydrochloric acid, to a final volume of about 500 mL. The mixture was filtered and the isolated solid was washed with H₂O (4×100 mL) then dried in vacuo. Trituration of this crude solid with EtOH provided the title compound as a pale tan solid. MS: m/z=261 (M+1).

(±)-6′-Amino-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione Step A. (±)-6′-Amino-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione

A stirred mixture of (±)-6′-carboxy-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione (described in Intermediate 1) (1.50 g, 5.76 mmol), and sodium azide (749 mg, 11.53 mmol) in conc. H₂SO₄ (30 mL) was heated to 50° C. for 2 h, then allowed to cool to ambient temperature. The mixture was adjusted to pH 8 by addition of 6 N aqueous NaOH and concentrated in vacuo to precipitate a solid. The precipitate was collected by filtration and washed extensively with H₂O. Drying in vacuo afforded the title compound as a light brown solid. MS: m/z=232 (M+1).

(±)-6′-Carboxy-3-methyl-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione Step A. (±)-6′-Bromo-3-methyl-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione

A mixture of 6-bromo-2-tetralone (1.00 g, 4.44 mmol) and methylamine hydrochloride (300 mg, 4.44 mol) in H₂O (1 mL) and EtOH (1.5 mL) was stirred at ambient temperature for 20 min. Potassium cyanide (289 mg, 4.44 mmol) was added and stirring was continued for 18 h. The mixture was added dropwise to a stirred solution of 1.0 N aqueous HCl (4.5 mL) at 0° C., then potassium cyanate (360 mg, 4.44 mmol) was added portionwise. The stirred mixture was heated to 95° C. and conc. hydrochloric acid (0.44 mL) was added dropwise. The reaction mixture was heated at this temperature for 1 h, allowed to cool, and extracted with CH₂Cl₂ (80 mL). The organic extract was dried over Na₂SO₄, filtered, and concentrated to dryness. The crude product was purified by silica gel chromatography, eluting with a gradient of CH₂Cl₂:MeOH —100:0 to 90:10, to provide a crude sample of the title compound (ca. 70% pure). Trituration with EtOH afforded the title compound as a pale solid. MS: m/z=311 (M+1).

Step B. (±)-6′-Carboxy-3-methyl-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione

To a stirred suspension of (±)-6′-bromo-3-methyl-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione (211 mg, 0.682 mmol) in THF (30 mL), at −70° C., was added dropwise ethyl magnesium bromide (1.0 M in THF, 1.37 mL, 1.37 mmol). The resulting mixture was stirred for 15 min, then tert-butyllithium (1.7 M in pentane, 1.61 mL, 2.73 mmol) was added dropwise. After a further 30 min, CO₂ (g) was bubbled into the reaction mixture until LCMS analysis indicated complete reaction. The mixture was allowed to warm slowly to ambient temperature and the THF was removed in vacuo. The residue was suspended in H₂O (20 mL) and the solution was adjusted to pH=1-2 by the addition of 1.0 N hydrochloric acid, then it was saturated with NaCl (s). The mixture was filtered and the isolated solid was washed with H₂O then dried in vacuo. Trituration of this crude solid with EtOH provided the title compound as a pale tan solid. MS: m/z=275 (M+1).

(±)-7′-Amino-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione Step A. 7-Bromo-2-tetralone

A solution of 3-bromophenylacetic acid (10.4 g, 48.4 mmol) in oxalyl chloride (50 mL, 0.57 mol) was stirred at ambient temperature for 5 min then at reflux for 5 h. The oxalyl chloride was removed in vacuo and the residue was dissolved in anhydrous CH₂Cl₂ (100 mL). This solution was added dropwise to a rapidly stirred, ice-cooled solution of AlCl₃ (23.2 g, 174.2 mmol) in CH₂Cl₂ (500 mL). A stream of ethylene gas was blown into the vortex of the stirred solution during the addition and the reaction temperature was kept at <5° C. The reaction mixture was allowed to warm to ambient temperature and then poured onto ice and stirred vigorously. The organic portion was removed and the aqueous layer extracted with CH₂Cl₂ (2×200 mL). The combined CH₂Cl₂ fractions were passed through a 2″ pad of silica and concentrated to give a thick, red oil. The crude product was purified by silica gel chromatography, eluting with a gradient of hexane:EtOAc —100:0 to 75:25, to provide the title compound as a pale yellow solid. MS: m/z=226 (M+1).

(±)-7′-Amino-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione

Essentially following the procedures described for Intermediate 1 and Intermediate 2, but using 7-bromo-2-tetralone in place of 6-bromo-2-tetralone, (±)-7′-amino-3′,4′-dihydro-1′H-spiro[imidazolidine-4,2′-naphthalene]-2,5-dione was prepared. MS: m/z=232 (M+1).

(±)Spiro[imidazolidine-4,2′-indane]-2,5-dione Step A. (±)-Spiro[imidazolidine-4,2′-indane]-2,5-dione

A stirred mixture of 2-indanone (3.0 g, 22.6 mmol), sodium cyanide (3.3 g, 67.3 mmol), and ammonium carbonate (22 g, 228 mol) in H₂O (50 mL) and EtOH (50 mL) was heated to 70° C. for 3 h, then allowed to cool to ambient temperature. The precipitate was collected by filtration and washed with H₂O (5×100 mL). Drying in vacuo afforded the title compound as a gray-brown solid. MS: m/z=202 (M+1).

(±)-5′-Amino-spiro[imidazolidine-4,2′-indane]-2,5-dione Step A. (±)-5′-Nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione

A solution of (±)-spiro[imidazolidine-4,2′-indane]-2,5-dione (3.0 g, 14.8 mmol, described in Intermediate 5) in conc. nitric acid (33 mL) was stirred at ambient temperature for 1 h. The reaction was then poured onto crushed ice and the resultant solid was isolated by filtration. The crude material was recrystallized from ethanol to give the title compound as a yellow solid. MS: m/z=248 (M+1).

Step B. (±)-5′-Amino-spiro[imidazolidine-4,2′-indane]-2,5-dione

To a suspension of (±)-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione (1.77 g, 7.16 mmol) in EtOAc (100 mL) and MeOH (100 mL) was added 10% Pd/C (400 mg) and the reaction stirred vigorously under hydrogen (ca. 1 atm). After 1 h, the catalyst was filtered off and the filtrate was concentrated to yield the title compound as a pale brown solid. MS: m/z=218 (M+1).

(±)-5′-Amino-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione Step A. 2-(Methylamino)indane-2-carbonitrile hydrochloride

To a mixture of 2-indanone (20.0 g, 151 mmol) in MeOH (20 mL) was added methylamine hydrochloride (10.2 g, 151 mmol). To the stirred mixture was added H₂O (20 mL) and a fine homogenous slurry developed. The reaction mixture was cooled to 0° C. and KCN (9.84 g, 151 mmol) in H₂O (20 mL) was added slowly over 30 min, such that the temperature did not exceed 10° C., then stirring was continued at ambient temperature for 18 h. The reaction mixture was extracted with Et₂O (250 mL) and the organic extract was washed with brine (50 mL) then dried over MgSO₄. HCl (g) was bubbled through the vigorously stirred solution for 10 minutes and a white solid precipitated. The solid was filtered, washed with Et₂O, and dried to yield the title compound. MS: m/z=173 (M+1).

Step B. (±)-3-Methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione

To a stirred mixture of 2-(methylamino)indane-2-carbonitrile hydrochloride from Step A (6.0 g, 28.8 mmol) in AcOH (45 mL) was added a solution of potassium cyanate (4.65 g, 57 mmol) in H₂O (6 mL) and the reaction mixture was stirred for 1 h. The mixture was poured into cold H₂O (150 mL) and the precipitate was isolated by filtration, washed with H₂O and air dried. The crude solid was suspended in 1 N HCl (30 mL) and stirred to 50° C. for 2 h. The reaction mixture was cooled, filtered, and the isolated solid washed with H₂O and dried in vacuo to yield the title compound. MS: m/z=217 (M+1).

Step C. (±)-3-Methyl-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione

To stirred fuming nitric acid (100 mL) was slowly added (±)-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione (4.5 g, 20.9 mmol) in portions over 30 min. The reaction mixture was diluted with H₂O (200 mL) and the precipitate was collected by filtration, washed with H₂O and dried in vacuo to give the title compound. MS: m/z=262 (M+1).

(±)-5′-Amino-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione

Essentially following the procedures described for Intermediate 6, but using (±)-3-methyl-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione in place of (±)-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione, the title compound was prepared. MS: m/z 232 (M+1);

(−)-5′-Amino-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione Step A. (−)-3-Methyl-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione

(±)-3-Methyl-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione (described in Intermediate 7) was dissolved in a mixture of MeOH, CH₃CN and diethylamine and the enantiomers were resolved by HPLC, utilizing a ChiralPak AD column and eluting with CH₃CN:MeOH —90:10. The first major peak to elute was (+)-3-methyl-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione and the second major peak to elute was (−)-3-methyl-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione, the title compound. MS: m/z=262 (M+1).

(−)-5′-Amino-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione

Essentially following the procedures described for Intermediate 6, but using (−)-3-methyl-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione in place of (±)-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione, the title compound was prepared. MS: m/z=232 (M+1).

5′-Amino-6′-chloro-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione, enantiomer B Step A. 5′-Amino-6′-chloro-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione, enantiomer B

(−)-5′-Amino-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione (265 mg, 1.15 mmol, described in Intermediate 8) was dissolved in AcOH (7 mL) and N-chlorosuccinimide (145 mg, 1.09 mmol) was added in one portion. The mixture was stirred at ambient temperature for 5 h, then the solvent was removed in vacuo. The residue was partitioned between saturated aqueous NaHCO₃ (20 mL) and CH₂Cl₂ (76 mL). The organic layer was dried (Na₂SO₄), filtered, and concentrated under reduced pressure. The crude product was purified by silica gel chromatography, eluting with a gradient of CH₂Cl₂:EtOAc —100:0 to 0:100, to give 5′-amino-4′-chloro-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione, which eluted first, and the title compound, which eluted second. MS: m/z 266 (M+1).

5′-Amino-4′-chloro-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione, enantiomer B Step A. 5′-Amino-4′-chloro-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione, enantiomer B

The title compound was obtained from the same reaction as Intermediate 9. The crude product was purified by silica gel chromatography, eluting with a gradient of CH₂Cl₂:EtOAc —100:0 to 0:100, to give the title compound, which eluted first, and 5′-amino-6′-chloro-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione, which eluted second. MS: m/z=266 (M+1).

(±)-5′-Amino-3-(benzyl)-spiro[imidazolidine-4,2′-indane]-2,5-dione Step A. (±)-1-(4-Methoxybenzyl)-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione

A mixture of (±)-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione (1.4 g, 5.66 mmol, described in Intermediate 6), 4-methoxybenzyl alcohol (0.94 g, 6.80 mmol), diethyl azodicarboxylate (1.48 g, 8.49 mmol), and triphenylphosphine (2.23 g, 8.49 mmol) in THF (15 mL) was stirred at ambient temperature for 3 days. The solvent was removed under reduced pressure and the residue was partitioned between saturated aqueous NaHCO₃ (15 mL) and CH₂Cl₂ (50 mL). The organic layer was dried (Na₂SO₄), filtered, and concentrated under reduced pressure. The crude product was purified by silica gel chromatography, eluting with a gradient of hexane:EtOAc —90:10 to 60:40, to give the title compound as a yellow solid. MS: m/z=368 (M+1).

Step B. (±)-3-Benzyl-1-(4-methoxybenzyl)-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione

To a solution of (±)-1-(4-methoxybenzyl)-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione from Step A (165 mg, 0.45 mmol) in DMF (1 mL) was added sodium hydride (18 mg of a 60% dispersion in mineral oil, 0.45 mmol). The mixture was stirred for 5 min at ambient temperature and benzyl bromide (230 mg, 1.35 mmol) was added. After 30 min, the mixture was partitioned between saturated aqueous NaHCO₃ (3 mL) and CHCl₃ (5 mL). The aqueous phase was extracted further with CHCl₃ (5 mL) and the combined organic layers were dried (Na₂SO₄), filtered, and concentrated under reduced pressure. The crude product was purified by silica gel chromatography, eluting with hexane:EtOAc —75:25, to give the title compound as a pale solid. MS: m/z=458 (M+1).

Step C. (±)-3-Benzyl-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione

To a stirred solution of (±)-3-benzyl-1-(4-methoxybenzyl)-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione from Step B (110 mg, 0.24 mmol) in acetonitrile (1.5 mL) was added dropwise a solution of ammonium cerium (IV) nitrate (395 mg, 0.72 mmol) in H₂O (1 mL). After 3 h at ambient temperature, the precipitate was isolated by filtration and dried in vacuo to afford the title compound as a yellow solid. MS: m/z=338 (M+1).

Step D. (±)-5′-Amino-3-benzyl-spiro[imidazolidine-4,2′-indane]-2,5-dione

To a solution of (±)-3-benzyl-5′-nitro-spiro[imidazolidine-4,2′-indane]-2,5-dione from Step C (80 mg, 0.24 mmol) in EtOAc (1.5 mL) and MeOH (1.5 mL) was added 10% Pd/C (5 mg) and the reaction mixture was stirred vigorously under hydrogen (ca. 1 atm). After 18 h, the catalyst was filtered off and the filtrate was concentrated to yield the title compound as a pale brown solid. MS: m/z=308 (M+1).

(±)-5′-Amino-3-(2-methylprop-1-yl)-spiro[imidazolidine-4,2′-indane]-2,5-dione

Essentially following the procedures described for Intermediate 11, but using 1-bromo-2-methylpropane in place of benzyl bromide, the title compound was prepared. MS: m/z=274 (M+1).

Sodium (2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate Step A. 4-Nitro-1,3-dihydro-2H-benzimidazol-2-one

Triphosgene (56 g, 188.8 mol) was added portionwise over 15 min to a solution of 3-nitro-1,2-phenylenediamine (25.5 g, 167 mol) in CH₃CN (400 mL) at 0° C. and the mixture was allowed to warm to ambient temperature after 30 min. The reaction was concentrated in vacuo, diluted with toluene (100 mL) and the solid precipitate was collected by filtration to give the title compound. MS: m/z=80 (M+1).

Step B. Dimethyl 2,2′-(4-nitro-2-oxo-1H-benzimidazole-1,3-diyl)diacetate

Cesium carbonate (3.6 g, 11.1 mmol) was added to a solution of 4-nitro-1,3-dihydro-2H-benzimidazol-2-one from Step A (990 mg, 5.5 mmol) and methyl bromoacetate (1.05 mL, 11.1 mmol) in DMF (25 mL). After 1.5 h, then reaction was quenched with H₂O and the solid precipitate was collected by filtration to give the title compound. MS: m/z 324 (M+1).

Step C. Methyl (2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate

A mixture of dimethyl 2,2′-(4-nitro-2-oxo-1H-benzimidazole-1,3-diyl)diacetate from Step B (270 mg, 0.84 mmol) and 10% Pd/C (50 mg) in MeOH (10 mL) was stirred under an atmosphere of hydrogen (ca. 1 atm). After 2 h, the reaction was filtered through a Celite pad and concentrated in vacuo. The crude solid was dissolved in toluene (3 mL) and p-toluenesulfonic acid monohydrate (2 mg, 0.011 mmol) was added. The mixture was heated at reflux for 30 min and then concentrated in vacuo to give the title compound. MS: m/z=262 (M+1).

Step D. Sodium (2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate

To a solution of methyl (2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate from Step C (367 mg, 1.40 mmol) in MeOH (40 mL) and CH₃CN (5 mL) was added 1.0 N sodium hydroxide (2.82 mL, 2.82 mmol) and the reaction mixture was stirred at room temperature for 18 h. The mixture was neutralized with 1 N aqueous HCl and concentrated in vacuo to give the title compound. MS: m/z 248 (M+1).

Sodium (6-methyl-2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate Step A. Methyl (6-methyl-2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate

To a solution of methyl (2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate (300 mg, 1.15 mmol, described in Intermediate 9) in DMF (5 mL) were added cesium carbonate (748 mg, 2.3 mmol) and iodomethane (326 mg, 2.3 mmol). After 16 h, the reaction mixture was quenched with brine (20 mL) and extracted with EtOAc (50 mL). The organic layer was dried over Na₂SO₄, filtered, and concentrated in vacuo to give the title compound. MS: m/z=276 (M+1).

Step B. Sodium (6-methyl-2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate

To a solution of methyl (6-methyl-2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate from Step A (225 mg, 0.817 mol) in MeOH (10 mL) was added 1.0 N sodium hydroxide (1.2 mL, 1.2 mmol). After 3 h, the reaction mixture was neutralized with 1 N aqueous HCl and concentrated to give the title compound. MS: m/z=262 (M+1).

Sodium (7-chloro-2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate Step A. 5-Chloro-2,1,3-benzoselenadiazole

A solution of 4-chlorobenzene-1,2-diamine (1.50 g, 10.5 mmol) in EtOH (15 mL) was heated to reflux and selenium dioxide (1.28 g, 11.5 mmol) was added. The reaction was refluxed for 30 min and cooled to ambient temperature. The precipitated solid was filtered, washed thoroughly with H₂O and dried under high vacuum to give the title compound. MS: m/z=219 (M+1).

Step B. 5-Chloro-4-nitro-2,1,3-benzoselenadiazole

A solution of 5-chloro-2,1,3-benzoselenadiazole from Step A (800 mg, 1.80 mmol) in conc. H₂SO₄ (12 mL) was cooled to 0° C. and 90% HNO₃ (0.8 mL) was added. After 30 min the reaction was cooled to 0° C. and diluted with H₂O (10 mL). The solid was filtered off and washed with cold H₂O to yield the title compound. MS: m/z=263 (M+1).

Step C. 5-Chloro-4-nitro-1,3-dihydro-2H-benzimidazol-2-one

A solution of 5-chloro-4-nitro-2,1,3-benzoselenadiazole from Step B (650 mg, 2.47 mmol) in conc. HCl (4 mL) and 48% aqueous HI (2 mL) was stirred at ambient temperature for 2 h. The reaction was diluted with a 1:1 saturated aqueous solution of NaHSO₄ and Na₂CO₃ (20 mL) and then adjusted to pH 10 using 10 M aqueous NaOH. The mixture was extracted with EtOAc (3×10 mL) and the organic extracts dried over Na₂SO₄, filtered, and concentrated in vacuo. The resulting dark red solid was dissolved in CH₃CN (4 mL) and phosgene was added (20% solution in toluene, 1.5 mL, 3.2 mmol). The reaction mixture was stirred for 1 h, then diluted with toluene. Filtration of the resultant solid gave the title compound. MS: m/z=214 (M+1).

Step D. Dimethyl 2,2′-(5-chloro-4-nitro-2-oxo-1H-benzimidazole-1,3-diyl)diacetate

Cesium carbonate (1.16 g, 3.60 mmol) was added to a solution of 5-chloro-4-nitro-1,3-dihydro-2H-benzimidazol-2-one from Step A (255 mg, 1.20 mmol) and methyl bromoacetate (0.23 mL, 2.40 mmol) in DMF (5 mL). After 1.5 h, the reaction was quenched with H₂O (30 mL) and the solid precipitate was collected by filtration to give the title compound. MS: m/z=359 (M+1).

Step E. Methyl (7-chloro-2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate

To a solution of dimethyl 2,2′-(5-chloro-4-nitro-2-oxo-1H-benzimidazole-1,3-diyl)diacetate (100 mg, 0.28 mmol) from Step D in AcOH (1.0 mL) and water (0.1 mL) was added fine granular iron (78 mg, 1.4 mmol) and the slurry was heated at 70° C. for 1 h. The reaction was cooled, filtered, concentrated and dissolved in DMF (4 mL). The DMF solution was added dropwise to H₂O (30 mL) with stirring and the precipitate was isolated by filtration to give the title compound. MS: m/z=296 (M+1).

Step F. Sodium (7-chloro-2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate

Essentially following the procedures described for Intermediate 14, but using methyl (7-chloro-2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate in place of methyl (6-methyl-2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate, the title compound was prepared MS: m/z=282 (M+1).

(2,7-Dioxo-5,6,7,8-tetrahydro-4H-imidazo[1,5,4-fg][1,6]benzodiazocin-1(2H)-yl)acetic acid Step A. tert-Butyl (4-nitro-2-oxo-2,3-dihydro-1H-benzimidazol-1-yl)acetate

Cesium carbonate (1.75 g, 5.4 mmol) was added to a solution of 4-nitro-1,3-dihydro-2H-benzimidazol-2-one (800 mg, 4.5 mmol, described in Intermediate 9) and tert-butyl bromoacetate (0.791 mL, 5.4 mmol) in DMF (15 mL). After 18 h, the reaction was quenched with H₂O (100 mL) and the solid precipitate was collected by filtration. The crude product was purified by silica gel chromatography, eluting with CH₂Cl₂:MeOH 95:5, to give the title compound. MS: m/z=294 (M+1).

Step B. Methyl 4-[3-(2-tert-butoxy-2-oxoethyl)-7-nitro-2-oxo-2,3-dihydro-1H-benzimidazol-1-yl]butanoate

Sodium hydride (26.7 mg of a 60% dispersion in mineral oil, 0.66 mmol) was added to a solution of tert-butyl (4-nitro-2-oxo-2,3-dihydro-1H-benzimidazol-1-yl)acetate from Step A (96 mg, 0.327 mmol) in DMF (5 mL). After 10 nm in, methyl 4-bromobutyrate (178 mg, 0.98 mmol) was added and the reaction was stirred at room temperature for 18 h. The mixture was quenched with H₂O and extracted with EtOAc. The organic extract was washed with brine, dried over Na₂SO₄, filtered, and concentrated in vacuo. The residue was purified by HPLC using a reversed phase C18 column and eluting with a gradient of H₂O:CH₃CN:CF₃CO₂H—90:10:0.1 to 5:95:0.1. Lyophilization provided the title compound. MS: m/z=394 (M+1).

Step C. Methyl 4-[7-amino-3-(2-tert-butoxy-2-oxoethyl)-2-oxo-2,3-dihydro-1H-benzimidazol-1-yl]butanoate

A mixture of methyl 4-[3-(2-tert-butoxy-2-oxoethyl)-7-nitro-2-oxo-2,3-dihydro-1H-benzimidazol-1-yl]butanoate from Step B (129 mg, 0.33 mmol) and 10% Pd/C (40 mg) in EtOH (30 mL) and EtOAc (15 mL) was stirred under an atmosphere of hydrogen (ca. 1 atm). After 1 h, the reaction was filtered through a Celite pad and concentrated in vacuo to give the title compound. MS: m/z=364 (M+1).

Step D. tert-Butyl (2,7-dioxo-5,6,7,8-tetrahydro-4H-imidazo[1,5,4-fg][1,6]benzodiazocin-1(2H)-yl)acetate

To a solution of methyl 4-[7-amino-3-(2-tert-butoxy-2-oxoethyl)-2-oxo-2,3-dihydro-1H-benzimidazol-1-yl]butanoate from Step C (119 mg, 0.327 mmol) in toluene (5 mL) was added p-toluenesulfonic acid monohydrate (2 mg, 0.011 mmol) and the mixture was heated at reflux. After 3 h, the reaction mixture was allowed to cool to ambient temperature and the mixture was concentrated in vacuo to give the title compound. MS: m/z=332 (M+1).

Step E. (2,7-Dioxo-5,6,7,8-tetrahydro-4H-imidazo[1,5,4-fg][1,6]benzodiazocin-1(2H)-yl)acetic acid

To a solution of tert-butyl (2,7-dioxo-5,6,7,8-tetrahydro-4H-imidazo[1,5,4-fg][1,6]benzodiazocin-1(2H)-yl)acetate from Step D (15 mg, 0.045 mmol) in CH₂Cl₂ (3 mL) was added TFA (1 mL). After 2 h, the mixture was concentrated under reduced pressure to give the title compound. MS: m/z 276 (M+1).

(8-Methyl-2,7-dioxo-5,6,7,8-tetrahydro-4H-imidazo[1,5,4-fg][1,6]benzodiazocin-1(2H)-yl)acetic acid Step A. tert-Butyl (8-methyl-2,7-dioxo-5,6,7,8-tetrahydro-4H-imidazo[1,5,4-fg][1,6]benzodiazocin-1(2H)-yl)acetate

Cesium carbonate (214 mg, 0.66 mmol) and iodomethane (93 mg, 0.66 mmol) were added to a solution of tert-butyl (2,7-dioxo-5,6,7,8-tetrahydro-4H-imidazo[1,5,4-fg][1,6]benzodiazocin-1(2H)-yl)acetate (109 mg, 0.33 mmol, described in Intermediate 13) in DMF (5 mL). After 18 h, the mixture was purified directly by HPLC using a reversed phase C18 column and eluting with a gradient of H₂O:CH₃CN:CF₃CO₂H—90:10:0.1 to 5:95:0.1. Lyophilization provided the title compound. MS: m/z=346 (M+1).

Step B. (8-Methyl-2,7-dioxo-5,6,7,8-tetrahydro-4H-imidazo[1,5,4-fg][1,6]-benzodiazocin-1(2H)-yl)acetic acid

To a solution of tert-butyl (8-methyl-2,7-dioxo-5,6,7,8-tetrahydro-4H-imidazo[1,5,4-fg][1,6]benzodiazocin-1(2H)-yl)acetate from Step A (45 mg, 0.13 mmol) in CH₂Cl₂ (6 mL) was added TFA (2 mL). After 2 h, the mixture was concentrated under reduced pressure to give the title compound. MS: m/z=290 (M+1).

Lithium (4-oxo-4,5-dihydropyrrolo[4,3,2-de]quinolin-1(3H)-yl)acetate Step A. N,N-Dimethyl-1-(4-nitro-1H-indol-3-yl)methanamine

N,N,N′,N′-Tetramethyldiaminomethane (2.2 mL, 15.6 mol) in acetic acid (30 mL) was added dropwise over 60 min to a solution of 4-nitroindole (2.30 g, 14.2 mol) in acetic acid (30 mL). After 3.5 h, the reaction was cooled to 0° C., and 20% aqueous sodium hydroxide was added to adjust the pH to 11. The mixture was extracted with CHCl₃ (3×300 mL) and the combined organic extracts were dried over Na₂SO₄, filtered, and concentrated in vacuo to give the title compound. MS: m/z=220 (M+1).

Step B. (4-Nitro-1H-indol-3-yl)acetonitrile

Potassium cyanide (9.20 g, 141 mmol) in H₂O (80 mL) was added to a solution of N,N-dimethyl-1-(4-nitro-1H-indol-3-yl)methanamine from Step A (3.10 g, 14.1 mmol) in DMF (80 mL) and the mixture was heated at reflux for 1 h, then cooled to ambient temperature and partitioned between H₂O (200 mL) and EtOAc (400 mL). The organic layer was dried over Na₂SO₄, filtered, and concentrated in vacuo. The crude product was purified by silica gel chromatography, eluting with a gradient of hexane:EtOAc—100:0 to 0:100, to give the title compound. MS: m/z=265 (M+Na+CH₃CN).

Step C. tert-Butyl[3-(cyanomethyl)-4-nitro-1H-indol-1-yl]acetate

Sodium hydride (198 mg of a 60% dispersion in mineral oil, 5.0 mmol) was added to a solution of (4-nitro-1H-indol-3-yl)acetonitrile from Step B (910 mg, 4.52 mmol) in DMF (15 mL). After 10 min, tert-butyl bromoacetate (0.801 mL, 5.4 mmol) was added dropwise and the reaction mixture was stirred at ambient temperature for 1.5 h. The mixture was partitioned between H₂O (50 mL) and EtOAc (100 mL) and the organic extract was washed with brine, dried over Na₂SO₄, filtered, and concentrated in vacuo. The crude product was purified by silica gel chromatography, eluting with a gradient of hexane:EtOAc—100:0 to 0:100, to give the title compound. MS: m/z=316 (M+1).

Step D. 2,2′-(4-Nitro-1H-indole-1,3-diyl)diacetic acid

To a solution of tert-butyl[3-(cyanomethyl)-4-nitro-1H-indol-1-yl]acetate from Step C (920 mg, 2.92 mol) in ethanol (50 mL) was added 1.0 N aqueous sodium hydroxide (14.6 mL, 14.6 mmol) and the mixture was heated at reflux for 18 h. An additional amount of 1.0 N sodium hydroxide (15 mL, 15 mmol) was added to the reaction, most of the EtOH was distilled out of the flask, and the mixture was heated at reflux for a further 21 h. The reaction mixture was cooled to 0° C. and concentrated HCl was added to adjust the pH to 1-2. The mixture was extracted with EtOAc (2×150 mL) and the combined organic extracts were dried over Na₂SO₄, filtered, and concentrated in vacuo to give the title compound. MS: m/z=279 (M+1).

Step E. Diethyl 2,2′-(4-nitro-1H-indole-1,3-diyl)diacetate

Concentrated sulfuric acid (0.02 mL) was added to a solution of 2,2′-(4-nitro-1H-indole-1,3-diyl)diacetic acid from Step D (742 mg, 2.67 mol) in EtOH (100 mL) and the mixture was heated at reflux for 9 h. The reaction mixture was allowed to cool to ambient temperature and was concentrated to a volume of 30 mL in vacuo. The solution was partitioned between EtOAc (300 mL) and aqueous NaHCO₃ (100 mL) and the organic layer was dried over Na₂SO₄, filtered, and concentrated in vacuo to give the title compound. MS: m/z=335 (M+1).

Step F. Diethyl 2,2′-(4-amino-1H-indole-1,3-diyl)diacetate

A mixture of diethyl 2,2′-(4-nitro-1H-indole-1,3-diyl)diacetate from Step E (140 mg, 0.419 mmol) and 10% Pd/C (20 mg) in EtOH (20 mL) was stirred under an atmosphere of hydrogen (ca. 1 atm). After 1.5 h, the reaction mixture was filtered through a Celite pad and concentrated in vacuo to give the title compound. MS: m/z=305 (M+1).

Step G. Ethyl (4-oxo-4,5-dihydropyrrolo[4,3,2-de]quinolin-1(3H)-yl)acetate

To a solution of diethyl 2,2′-(4-amino-1H-indole-1,3-diyl)diacetate from Step F (83 mg, 0.273 mmol) in toluene (8 mL) was added p-toluenesulfonic acid monohydrate (5 mg, 0.026 mmol) and the mixture was heated at reflux. After 2 h, the reaction was allowed to cool to ambient temperature and the mixture was partitioned between EtOAc (40 mL) and aqueous NaHCO₃ (15 mL). The organic layer was washed with brine, dried over Na₂SO₄, filtered, and concentrated in vacuo. The crude product was purified by silica gel chromatography, eluting with a gradient of CH₂Cl₂:MeOH—100:0 to 92:8, to give the title compound. MS: m/z=259 (M+1).

Step H. Lithium (4-oxo-4,5-dihydropyrrolo[4,3,2-de]quinolin-1(3H)-yl)acetate

To a solution of ethyl (4-oxo-4,5-dihydropyrrolo[4,3,2-de]quinolin-1(3H)-yl)acetate from Step G (79 mg, 0.306 mmol) in ethanol (3 mL) and water (0.5 mL) was added dropwise 1.0 N aqueous lithium hydroxide (0.34 mL, 0.34 mmol). After 5 min, 1 N aqueous HCl was added to adjust the mixture to pH 7 and the solution was concentrated in vacuo to give the title compound. MS: m/z=231 (M+1).

Lithium (7-methyl-4-oxo-4,5-dihydropyrrolo[4,3,2-de]quinolin-1(3H)-yl)acetate Step A. 2,5-Dimethyl-3-nitroaniline

To a stirred solution of p-xylene (10.4 g, 97.9 mmol) in concentrated sulfuric acid (20 mL), cooled in an ice bath, was added 90% nitric acid (12.4 mL, 264 mmol) dropwise over 50 min. The resulting mixture was heated to 80° C. for 2 h, then poured onto ice and extracted with CH₂Cl₂ (2×400 mL). The combined organic extracts were washed with saturated aqueous NaHCO₃, then brine, then dried over Na₂SO₄, filtered, and concentrated in vacuo. The crude product was partially purified by silica gel chromatography, eluting with a gradient of hexane:EtOAc—90:10 to 60:40. The resulting solid was recrystallized from CH₂Cl₂ to yield 2,5-dimethyl-1,3-dinitrobenzene as a white solid. 2,5-Dimethyl-1,3-dinitrobenzene (3.68 g, 18.8 mmol) was dissolved in AcOH (35 mL) and iron powder (1.95 g, 34.9 mmol) was added. The mixture was heated to 110° C. for 3 h, then filtered through a pad of Celite, washing with EtOAc and H₂O. The filtrate was concentrated in vacuo to remove most of the solvent and the residue was partitioned between saturated aqueous NaHCO₃ (200 mL) and EtOAc (200 mL). The organic layer was washed with brine, then dried over Na₂SO₄, filtered, and concentrated in vacuo. The crude product was purified by silica gel chromatography, eluting with a gradient of hexane:EtOAc—100:0 to 60:40, to give the title compound as a yellow solid. MS: m/z=167 (M+1).

Step B. 6-Methyl-4-nitro-1H-indole

A solution of 2,5-dimethyl-3-nitroaniline from Step A (1.21 g, 7.26 mmol) and p-toluenesulfonic acid monohydrate (2 mg, 0.011 mmol) in freshly distilled triethyl orthoformate (1.65 mL, 9.92 mmol) was heated at 120° C. for 45 min in a distillation apparatus, and about 0.4 mL of EtOH distilled over. Vacuum distillation of the residual solution yielded ethyl 2,5-dimethyl-3-nitrophenylimidoformate (b.p.=146° C., ca. 2 mm Hg) as a pale yellow solid. To a solution of diethyl oxalate (868 mg, 5.94 mmol) in DMF (2 mL), at 0° C., was added potassium ethoxide (435 mg, 5.17 mmol) and the resulting solution was added to a solution of ethyl 2,5-dimethyl-3-nitrophenylimidoformate (880 mg, 3.96 mmol) in DMSO (3 mL). The reaction mixture was heated at 40° C. for 1 h than quenched with H₂O (30 mL) and extracted with EtOAc (2×50 mL). The combined organic layers were washed with brine, then dried over Na₂SO₄, filtered, and concentrated in vacuo. The crude product was purified by silica gel chromatography, eluting with a gradient of hexane:EtOAc—100:0 to 0:100, to give the title compound. MS: m/z=177 (M+1).

Lithium (7-methyl-4-oxo-4,5-dihydropyrrolo[4,3,2-de]quinolin-1(3H)-yl)acetate

Essentially following the procedures described for Intermediate 18, but using 6-methyl-4-nitro-1H-indole in place of 4-nitroindole, the title compound was prepared. MS: m/z 245 (M+1).

Lithium (4-oxo-2α,3,4,5-tetrahydropyrrolo[4,3,2-de]quinolin-1(2H)-yl)acetate, enantiomer B

Step A. Methyl (4-nitro-1H-indol-3-yl)(oxo)acetate

Diphosphoryl chloride (0.938 mL, 6.8 mol) was added dropwise to a solution of 4-nitroindole (1 g, 6.2 mol) and methylpyrrolidinyl glyoxylate (Downie et al., Tetrahedron, 1993, 49, 4015-4034) (1.1 g, 6.8 mmol) at 0° C. and the mixture was allowed to warm to ambient temperature over 3 h. MeOH, then saturated aqueous NaHCO₃ were added to the reaction at 0° C. and the solution was extracted with CH₂Cl₂ (3×50 mL). The combined organic extracts were dried over Na₂SO₄, filtered, and concentrated in vacuo until crystals formed. The crystals were collected by vacuum filtration and two more crops were isolated from the filtrate to give the title compound. MS: m/z=249 (M+1).

Step B. (±)-Methyl(4-nitro-2,3-dihydro-1H-indol-3-yl)acetate

Triethylsilane (13 mL, 80.6 mmol) was added to a solution of methyl (4-nitro-1H-indol-3-yl)(oxo)acetate from Step A (1.0 g, 4.0 mmol) in TFA (15 mL). After 3 h, the reaction mixture was concentrated in vacuo and the residue was purified by silica gel chromatography, eluting with a gradient of CHCl₃:MeOH—100:0 to 98:2, to give the title compound. MS: m/z 237 (M+1).

Step C. (±)-Ethyl methyl 2,2′-(4-nitro-2,3-dihydro-1H-indole-1,3-diyl)diacetate

To a solution of (±)-methyl(4-nitro-2,3-dihydro-1H-indol-3-yl)acetate from Step B (700 mg, 3.0 mmol), sodium bicarbonate (471 mg, 4.4 mmol), and potassium iodide (98 mg, 0.59 mmol) in acetone (15 mL) was added ethyl bromoacetate (9.9 mL, 88.9 mmol). The mixture was heated at reflux for 18 h, then cooled to ambient temperature and concentrated in vacuo. The residue was partitioned between H₂O (15 mL) and EtOAc (2×40 mL) and the organic extracts were washed with brine, dried over Na₂SO₄, filtered, and concentrated in vacuo to a volume of 50 mL. Hexane was added to the EtOAc solution and a precipitate formed. The desired crystals were collected by vacuum filtration to give the title compound. MS: m/z 323 (M+1).

Step D. (±)-Ethyl methyl 2,2′-(4-amino-2,3-dihydro-1H-indole-1,3-diyl)diacetate

A mixture of (±)-ethyl methyl 2,2′-(4-nitro-2,3-dihydro-1H-indole-1,3-diyl)diacetate from Step C (550 mg, 1.7 mmol) and 10% Pd/C (40 mg) in EtOH (10 mL) was stirred under an atmosphere of hydrogen (ca. 1 atm). After 3 h, the reaction was filtered through a Celite pad and concentrated in vacuo to give the title compound. MS: m/z=293 (M+1).

Step E. Ethyl (4-oxo-2α,3,4,5-tetrahydropyrrolo[4,3,2-de]quinolin-1(2H)-yl)acetate, enantiomer B

To a solution of (±)-ethyl methyl 2,2′-(4-amino-2,3-dihydro-1H-indole-1,3-diyl)diacetate from Step D (490 mg, 1.70 mmol) in toluene (35 mL) was added p-toluenesulfonic acid monohydrate (5 mg, 0.026 mmol) and the mixture was heated at reflux for 48 h. The mixture was cooled to ambient temperature and was partitioned between saturated aqueous NaHCO₃ (5 mL) and EtOAc (40 mL). The organic layer was dried over Na₂SO₄, filtered, and concentrated in vacuo. The crude product was purified by silica gel chromatography, eluting with a gradient of CHCl₃:EtOAc—90:10 to 40:60, to give the racemic product. The enantiomers were resolved by HPLC, utilizing a Chiralpak AS column and eluting with MeOH. The first major peak to elute was ethyl (4-oxo-2α,3,4,5-tetrahydropyrrolo[4,3,2-de]quinolin-1(2H)-yl)acetate, enantiomer A, and the second major peak to elute was ethyl (4-oxo-2α,3,4,5-tetrahydropyrrolo[4,3,2-de]quinolin-1(2H)-yl)acetate, enantiomer B, the title compound. MS: m/z=261 (M+1).

Step F. Lithium (4-oxo-2α,3,4,5-tetrahydropyrrolo[4,3,2-de]quinolin-1(2H)-yl)acetate, enantiomer B

To a solution of ethyl (4-oxo-2α,3,4,5-tetrahydropyrrolo[4,3,2-de]quinolin-1(2H)-yl)acetate, enantiomer B, from Step E (55 mg, 0.211 mmol) in THF (1 mL), EtOH (1 mL) and H₂O (1 mL) was added 1.0 N lithium hydroxide (0.232 mL, 0.232 mmol). After 15 min, 1 N aqueous HCl was added to adjust the solution to pH 7 and the mixture was concentrated in vacuo to give the title compound. MS: m/z 233 (M+1).

Intermediates 21-27

Essentially following analogous procedures to those outlined for Intermediates 13-20, the compounds listed in Table 1 were prepared. The most relevant analogous procedure for each intermediate is listed in the Table. The requisite starting materials were commercially available, described in the literature, or readily synthesized by one skilled in the art of organic synthesis. In some cases, straightforward protecting group strategies were applied.

TABLE 1

Relevant Literature Intermediate R^(a) MS (M + 1) Intermediate(s) Reference 21

247 14, 20 22

330 14 23

324 14 24

262 15 25

296 15 26

262 13 Lyle & LaMattina J. Org. Chem. 1975, 40, 438-441. 27

276 14 Lyle & LaMattina J. Org. Chem. 1975, 40, 438-441.

Example 1

2-(2,5-Dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)-N-(2′-oxo-1,1′,2′,3-tetrahydrospiro[indene-2,3′-pyrrolo[2,3-b]pyridin]-5-yl)acetamide

A mixture of (−)-5′-amino-3-methyl-spiro[imidazolidine-4,2′-indane]-2,5-dione (23 mg, 0.10 mmol, described in Intermediate 8), sodium (2,5-dioxo-5,6-dihydro-4H-imidazo[1,5,4-de]quinoxalin-1(2H)-yl)acetate (21 mg, 0.077 mmol, described in Intermediate 13), EDC (29 mg, 0.15 mmol), HOBT (23 mg, 0.153 mmol) was stirred in DMF (3 mL) at ambient temperature for 18 h. The reaction mixture was purified directly by HPLC using a reversed phase C18′ column and eluting with a gradient of H₂O:CH₃CN:CF₃CO₂H—90:10:0.1 to 5:95:0.1. The pure, product-containing fractions were combined and concentrated in vacuo to yield the title compound. MS: m/z 461 (M+1). HRMS: m/z=461.1575; calculated m/z=461.1568 for C₂₃H₂₁N₆O₅.

EXAMPLES 2-14

Essentially following the procedures outlined for Example 1 the compounds listed in Table 2 were prepared. The requisite carboxylic acids were commercially available, described in the literature, synthesized according to methodology described herein (vide supra), or readily synthesized by one skilled in the art of organic synthesis. In some cases, straightforward protecting group strategies were applied.

TABLE 2

Example R^(b) MS (M + 1) 2

475 3

444 4

475 5

489 6

509 7

543 8

537 9

475 10

489 11

503 12

458 13

446 14

460

While the invention has been described and illustrated with reference to certain particular embodiments thereof, those skilled in the art will appreciate that various adaptations, changes, modifications, substitutions, deletions, or additions of procedures and protocols may be made without departing from the spirit and scope of the invention. For example, effective dosages other than the particular dosages as set forth herein above may be applicable as a consequence of variations in the responsiveness of the mammal being treated for any of the indications with the compounds of the invention indicated above. Likewise, the specific pharmacological responses observed may vary according to and depending upon the particular active compounds selected or whether there are present pharmaceutical carriers, as well as the type of formulation and mode of administration employed, and such expected variations or differences in the results are contemplated in accordance with the objects and practices of the present invention. It is intended, therefore, that the invention be defined by the scope of the claims which follow and that such claims be interpreted as broadly as is reasonable. 

1. A compound of formula I:

wherein: A¹ and A² are each independently selected from: (1) a bond, (2) —CR¹³R¹⁴—, wherein R¹³ and R¹⁴ are each independently selected from: hydrogen, hydroxy, halo, and C₁₋₆ alkyl which is unsubstituted or substituted with 1-6 fluoro, where one of A¹ and A² is optionally absent; B¹ and B⁴ are each independently selected from: ═C—, —C(R¹)—, and —N—; B² and B³ are each independently selected from: a bond, ═C(R¹)—, —CR¹R²—, —C(═O)—, —C(═S)—, ═N—, —N(R¹)—, —O—, —S—, and —SO₂—, where one of B² and B³ is optionally absent; D¹ and D² are each independently selected from: ═C(R¹)—, —CR¹R²—, —C(═O)—, —C(═S)—, ═N—, —N(R¹)—, —O—, —S—, and —SO₂—; T, U and V are each independently selected from: ═C(R¹)—, and ═N—, where at least one of T, U, and V is ═C(R¹)—; W, X, Y, and Z are each independently selected from: a bond, ═C(R¹)—, —CR¹R²—, —C(═O)—, —C(═S)—, ═N—, —N(R¹)—, —O—, —S—, —S(O)— and —SO₂—; R¹ and R² are each independently selected from: (1) hydrogen; (2) —C₁₋₆alkyl which is unsubstituted or substituted with 1-7 substituents each independently selected from: (a) halo, (b) hydroxy, (c) —O—C₁₋₆alkyl, (d) —C₃₋₆cycloalkyl, (e) phenyl or heterocycle, wherein heterocycle is selected from: azetidinyl, imidazolyl, oxazolyl, pyridyl, pyrimidinyl, pyrazinyl, pyridazinyl, piperidinyl, azepinyl, piperazinyl, pyrazolyl, pyrrolidinyl, thiazolyl, thienyl, triazolyl, tetrazolyl, tetrahydrofuryl and morpholinyl, which phenyl or heterocycle is unsubstituted or substituted with 1-5 substituents each independently selected from: —C₁₋₆alkyl, —O—C₁₋₆alkyl, halo, hydroxy, trifluoromethyl, —OCF₃, and oxo, (f) —CO₂R⁹, wherein R⁹ is independently selected from: hydrogen, —C₃₋₆cycloalkyl, benzyl, phenyl, and —C₁₋₆alkyl which is unsubstituted or substituted with 1-6 fluoro, (g) —NR¹⁰R¹¹, wherein R¹⁰ and R¹¹ are each independently selected from: hydrogen, —C₅₋₆cycloalkyl, benzyl, phenyl, —COR⁹, —SO₂R¹², and —C₁₋₆alkyl which is unsubstituted or substituted with 1-6 fluoro, (h) —SO₂R¹², wherein R¹² is independently selected from: —C₅₋₆cycloalkyl, benzyl, phenyl, and —C₁₋₆alkyl which is unsubstituted or substituted with 1-6 fluoro, (i) —CONR^(10a)R^(11a), wherein R^(10a) and R^(11a) are each independently selected from: hydrogen, —C₅₋₆cycloalkyl, benzyl, phenyl, and —C₁₋₆alkyl which is unsubstituted or substituted with 1-6 fluoro, or R^(10a) and R^(11a) are joined to form a ring selected from azetidinyl, pyrrolidinyl, piperidinyl, piperazinyl, and morpholinyl, which ring is unsubstituted or substituted with 1-5 substituents each independently selected from: —C₁₋₆alkyl, —O—C₁₋₆alkyl, halo, hydroxyl, phenyl and benzyl, (j) trifluoromethyl, (k) —OCO₂R⁹, (l) —(NR^(10a))CO₂R⁹, (m) —O(CO)NR^(10a)R^(11a), (n) —(NR⁹)(CO)NR^(10a)R^(11a), and (o)—O—C₃₋₆cycloalkyl, (3) —C₃₋₆cycloalkyl, which is unsubstituted or substituted with 1-7 substituents each independently selected from: (a) halo, (b) hydroxy, (c) —O—C₁₋₆alkyl, (d) trifluoromethyl, (e) phenyl which is unsubstituted or substituted with 1-5 substituents independently selected from: —C₁₋₆alkyl, —O—C₁₋₆alkyl, halo, hydroxy, and trifluoromethyl, (4) phenyl or heterocycle, wherein heterocycle is selected from: pyridyl, pyrimidinyl, pyrazinyl, thienyl, pyridazinyl, pyrrolidinyl, azetidinyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, imidazolyl, triazolyl, tetrazolyl, azepinyl, benzimidazolyl, benzopyranyl, benzofuryl, benzothiazolyl, benzoxazolyl, chromanyl, furyl, imidazolinyl, indolinyl, indolyl, quinolinyl, isoquinolinyl, tetrahydroquinolinyl, isoindolinyl, tetrahydroisoquinolinyl, 2-oxopiperazinyl, 2-oxopiperidinyl, 2-oxopyrrolidinyl, pyrazolidinyl, pyrazolyl, pyrrolyl, quinazolinyl, tetrahydrofuryl, thiazolinyl, purinyl, naphthyridinyl, quinoxalinyl, 1,3-dioxolanyl, oxadiazolyl, piperidinyl, tetrahydropyranyl, tetrahydrothienyl, tetrahydrothiopyranyl, and morpholinyl, which phenyl or heterocycle is unsubstituted or substituted with 1-5 substituents each independently selected from: (a) —C₁₋₆alkyl, which is unsubstituted or substituted with 1-6 fluoro, (b) halo, (c) hydroxy, (d) —O—C₁₋₆alkyl, which is unsubstituted or substituted with 1-6 fluoro, (e) —C₃₋₆cycloalkyl, (f) phenyl or heterocycle, wherein heterocycle is selected from: pyridyl, pyrimidinyl, pyrazinyl, thienyl and morpholinyl, which phenyl or heterocycle is unsubstituted or substituted with 1-5 substituents each independently selected from: —C₁₋₆alkyl, —O—C₁₋₆alkyl, halo, hydroxy and trifluoromethyl, (g) —CO₂R⁹, (h) —(CO)R⁹, (i) —NR¹⁰R¹¹, (j) —CONR¹⁰R¹¹, (k) oxo, (l) —SR¹², (m) —S(O)R¹², (n) —SO₂R¹², and (o)—CN, (5) halo, (6) oxo, (7) hydroxy, (8) —O—C₁₋₆alkyl, which is unsubstituted or substituted with 1-5 halo, (9) —CN, (10) —CO₂R⁹, (11) —NR¹⁰R¹¹, (12) —SO₂R¹², (13) —CONR^(10a)R^(11a), (14) —OCO₂R⁹, (15) —(NR^(10a))CO₂R⁹, (16) —O(CO)NR^(10a)R^(11a), (17) —(NR⁹)(CO)NR^(10a)R^(11a), (18) —(CO)—(CO)NR^(10a)R^(11a), and (19) —(CO)—(CO)OR⁹; R⁴ is selected from: hydrogen, C₅₋₆ cycloalkyl, benzyl, phenyl and C₁₋₆ alkyl which is unsubstituted or substituted with 1-6 fluoro, R^(5a), R^(5b) and R^(5c) are each independently selected from: hydrogen, C₁₋₆ alkyl, —O—C₁₋₆alkyl, —OCF₃, trifluoromethyl, halo, hydroxy and —CN; R⁶ is selected from: (1) hydrogen, (2) —C₁₋₆alkyl or —C₃₋₆cycloalkyl, unsubstituted or substituted with 1-7 substituents independently selected from: (a) halo, (b) hydroxy, (c) —O—C₁₋₆alkyl, (d) —C₃₋₆cycloalkyl, (e) phenyl which is unsubstituted or substituted with 1-5 substituents each independently selected from: —C₁₋₆alkyl, —O—C₁₋₆alkyl, halo, hydroxy, and trifluoromethyl, (f) —CO₂R⁹, (g) —NR¹⁰R¹¹, (h) —CONR¹⁰R¹¹, (i) —SO₂R¹², and (j) trifluoromethyl (3) phenyl or heterocycle, wherein heterocycle is selected from: pyridyl, pyrimidinyl, pyrazinyl, thienyl and morpholinyl, which phenyl or heterocycle is unsubstituted or substituted with 1-5 substituents each independently selected from: —C₁₋₆alkyl, —O—C₁₋₆alkyl, halo, hydroxy, and trifluoromethyl; m is 1 or 2; n is 1 or 2; and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.
 2. The compound of claim 1, having the formula Ia:

and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.
 3. The compound of claim 1, having the formula Ib:

and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.
 4. The compound of claim 1, having the formula Ic:

and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.
 5. The compound of claim 1, having the formula Id:

and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.
 6. The compound of claim 1, having the formula Ie:

and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.
 7. The compound of claim 1, wherein B¹ is selected from: ═C—, —C(R¹)—, and —N—.
 8. The compound of claim 1, wherein B⁴ is selected from: ═C—, —C(H)—, and —N—.
 9. The compound of claim 1, wherein B² is selected from: ═C(R¹)—, —CR¹R²—, and —C(═O)—, where R¹ and R² are defined herein.
 10. The compound of claim 1, wherein, B³ is a bond.
 11. The compound of claim 1, wherein D¹ is selected from: —CR¹R²—, and —N(R¹)—.
 12. The compound of claim 1, wherein D² is selected from: —CR¹R²— and —N(R¹)—.
 13. The compound of claim 1, wherein T is selected from: ═C(R¹)— and ═N—, U is selected from: ═C(R¹)— and ═N—, and V is ═C(H)—.
 14. The compound of claim 1, wherein W is selected from: a bond, —CR¹R²—, and —C(═O)—, X is selected from: a bond, —CR¹R²— and —C(═O)—, Y is selected from: a bond, —CR¹R²— and —C(═O)—, and Z is selected from: a bond, —CR¹R²—, and —C(═O)—.
 15. The compound of claim 1, wherein R¹ and R² are each independently selected from: (1) hydrogen; (2) —C₁₋₆alkyl which is unsubstituted or substituted with 1-5 substituents each independently selected from: (a) halo, (b) hydroxy, (c) —O—C₁₋₁₆alkyl, (d) —C₃₋₆cycloalkyl, (e) phenyl or heterocycle, wherein heterocycle is selected from: azetidinyl, imidazolyl, oxazolyl, pyridyl, pyrimidinyl, pyrazinyl, piperidinyl, piperazinyl, pyrrolidinyl, thiazolyl, thienyl, triazolyl, tetrazolyl, tetrahydrofuryl and morpholinyl, which phenyl or heterocycle is unsubstituted or substituted with 1-3 substituents each independently selected from: —C₁₋₄alkyl, —O—C₁₋₄alkyl, halo, hydroxy, trifluoromethyl and —OCF₃, (f) —CO₂R⁹, wherein R⁹ is selected from: hydrogen and —C₁₋₄alkyl, (g) —NR¹⁰R¹¹, wherein R¹⁰ and R¹¹ are each independently selected from: hydrogen, —COR⁹, —SO₂R¹² and —C₁₋₄alkyl which is unsubstituted or substituted with 1-3 fluoro, (h) —CONR^(10a)R^(11a), wherein R^(10a) and R^(11a) are each independently selected from: hydrogen, —C₅₋₆cycloalkyl, and —C₁₋₄alkyl which is unsubstituted or substituted with 1-3 fluoro, or R^(10a) and R^(11a) are joined to form a ring selected from azetidinyl, pyrrolidinyl, piperidinyl, piperazinyl and morpholinyl, which ring is unsubstituted or substituted with 1-3 substituents each independently selected from: —C₁₋₄alkyl, —O—C₁₋₄alkyl, halo and hydroxyl, and (i) —(NR^(10a))CO₂R⁹, (3) —C₃₋₆cycloalkyl, which is unsubstituted or substituted with 1-3 substituents each independently selected from: halo, hydroxy and —O—C₁₋₆alkyl, (4) phenyl or heterocycle, wherein heterocycle is selected from: pyridyl, pyrimidinyl, pyrazinyl, thienyl, pyrrolidinyl, azetidinyl, thiazolyl, oxazolyl, isoxazolyl, imidazolyl, triazolyl, tetrazolyl, benzimidazolyl, benzoxazolyl, imidazolinyl, indolinyl, indolyl, quinolinyl, isoquinolinyl, tetrahydroquinolinyl, isoindolinyl, tetrahydroisoquinolinyl, 2-oxopiperazinyl, 2-oxopiperidinyl, 2-oxopyrrolidinyl, quinazolinyl, tetrahydrofuryl, naphthyridinyl, quinoxalinyl, 1,3-dioxolanyl, oxadiazolyl, piperidinyl, tetrahydropyranyl and morpholinyl, which phenyl or heterocycle is unsubstituted or substituted with 1-3 substituents each independently selected from: halo, hydroxy, —C₃₋₆cycloalkyl, —CO₂R⁹, —NR¹⁰R¹¹, —CONR¹⁰R¹¹, —C₁₋₄alkyl, which is unsubstituted or substituted with 1-3 fluoro, and —O—C₁₋₄alkyl, which is unsubstituted or substituted with 1-6 fluoro, (5) halo, (6) hydroxy, (7) —O—C₁₋₄alkyl which is unsubstituted or substituted with 1-3 halo, (8) —CN, (9) —CO₂R⁹, (10) —NR¹⁰R¹¹, (11) —CONR^(10a)R^(11a), and (12) —(NR^(10a))CO₂R⁹, and pharmaceutically acceptable salts thereof and individual enantiomers and diastereomers thereof.
 16. The compound of claim 1, wherein R⁴ is selected from: hydrogen and —C₁₋₆alkyl, which is unsubstituted or substituted with fluoro, and R^(5a), R^(5b) and R^(5c) are each independently selected from hydrogen, C₁₋₆alkyl and halo.
 17. The compound of claim 1, wherein R⁶ is selected from: hydrogen, —C₁₋₄alkyl which is unsubstituted or substituted with 1-5 substituents each independently selected from: halo, hydroxy, —C₃₋₆cycloalkyl and phenyl, and phenyl or heterocycle, wherein heterocycle is selected from: pyridyl, pyrimidinyl and pyrazinyl.
 18. A compound selected from:

and pharmaceutically acceptable salts and individual diastereomers thereof.
 19. A pharmaceutical composition which comprises an inert carrier and the compound of claim
 1. 20. A method for antagonism of CGRP receptor activity in a mammal which comprises the administration of an effective amount of the compound of claim
 1. 21. A method for treating, controlling, ameliorating or reducing the risk of headache, migraine or cluster headache in a mammalian patient in need of such which comprises administering to the patient a therapeutically effective amount of the compound of claim
 1. 22. A method of treating or preventing migraine headaches, cluster headaches, and headaches, said method comprising the co-administration, to a person in need of such treatment, of: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt, thereof; and a therapeutically effective amount of a second agent selected from serotonin agonists, analgesics, anti-inflamatory agents, anti-hypertensives and anticonvulsants.
 23. The method of claim 22, wherein said second agent is selected from a 5HT_(IB/ID) agonist, a 5HT_(ID) agonist, and a 5HT_(IF) agonist.
 24. The method of claim 23, wherein said second agent is selected from rizatriptan, sumatriptan, naratriptan, zolmitriptan, almotriptan, eletriptan, avitriptan, frovatriptan, LY334370 and PNU-142633.
 25. The method of claim 22, wherein said second agent is selected from ergotamine and dihydroergotamine.
 26. The method of claim 22, wherein said second agent is aspirin or acetaminophen.
 27. The method of claim 22, wherein said second agent is a glucocorticoid.
 28. The method of claim 22, wherein said second agent is a non-steroidal anti-inflammatory agent.
 29. The method of claim 28, wherein said second agent is selected from ibuprofen, ketoprofen, fenoprofen, naproxen, indomethacin, sulindac, meloxicam, piroxicam, tenoxicam, lornoxicam, ketorolac, etodolac, mefenamic acid, meclofenamic acid, flufenamic acid, tolfenamic acid, diclofenac, oxaprozin, apazone, nimesulide, nabumetone, tenidap, etanercept, tolmetin, phenylbutazone, oxyphenbutazone, diflunisal, salsalate, olsalazine and sulfasalazine.
 30. The method of claim 22, wherein said second agent is an anticonvulsant selected from topiramate, zonisamide, divalproex sodium, pregabalin, gabapentin, levetiracetam, lamotrigine and tiagabine.
 31. The method of claim 22, wherein said second agent is selected from angiotensin II antagonists, angiotensin I antagonists, angiotensin converting enzyme inhibitors, and renin inhibitors.
 32. The method of claim 31, wherein said second agent is selected from losartan, candesartan, candesartan cilexetil, irbesartan, valsartan, eprosartan, telmisartan, olmesartan, medoxomil, captopril, benazepril, quinapril, perindopril, ramipril, trandolapril, lisinopril, and enalapril.
 33. A method of treating or preventing migraine headaches, cluster headaches, and headaches, said method comprising the co-administration, to a person in need of such treatment, of: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from anti-anxiety agents and neuroleptics.
 34. The method of claim 33, wherein said second agent is selected from, diazepam, alprazolam, chlordiazepoxide, olanzapine, droperidol, prochlorperazine, chlorpromazine and quetiapine.
 35. A method of treating or preventing migraine headaches, cluster headaches, and headaches, said method comprising the co-administration, to a person in need of such treatment, of: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from beta-blockers and calcium channel blockers.
 36. The method of claim 35, wherein said second agent is selected from timolol, propanolol, atenolol, metoprolol, nadolol, flunarizine, diltiazem, amlodipine, felodipine, nisolipine, isradipine, nimodipine, lomerizine, verapamil, nifedipine, prochlorperazine and civamide.
 37. A method of treating or preventing migraine headaches, cluster headaches, and headaches, said method comprising the co-administration, to a person in need of such treatment, of: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from anti-depressants, selective serotonin reuptake inhibitors, and NE reuptake inhibitors.
 38. The method of claim 37, wherein said second agent is selected from amitriptyline, nortriptyline, clomipramine, imipramine, venlafaxine, doxepin, protriptyline, desipramine, trimipramine, fluoxetine, paroxetine, sertraline, duloxetine, escitalopram, and citalopram.
 39. A method of treating or preventing migraine headaches, cluster headaches, and headaches, said method comprising the co-administration, to a person in need of such treatment, of: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from botulinum toxins A or B.
 40. A method of treating or preventing migraine headaches, cluster headaches, and headaches, said method comprising the co-administration, to a person in need of such treatment, of: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from vanilloid receptor antagonists, adenosine 1 antagonists, NR2B antagonists, substance P antagonists, granzyme B inhibitors, endothelin antagonists, norepinephrin precursors, nitric oxide synthase inhibitors, neuroleptics, bradykinin antagonists, gap junction inhibitors, AMPA/KA antagonists, sigma receptor agonists, chloride channel enhancers, monoamine oxidase inhibitors, opioid agonists, and leukotriene receptor antagonists.
 41. The method of claim 40, wherein said second agent is selected from montelukast and zafirlukast.
 42. The method of claim 40, wherein said second agent is aprepitant.
 43. A method of treating or preventing migraine headaches, cluster headaches, and headaches, said method comprising the co-administration, to a person in need of such treatment, of: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from the group consisting of anti-emetics, prokinetics, and histamine H1 antagonists.
 44. A pharmaceutical composition comprising: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from serotonin agonists, analgesics, anti-inflamatory agents, and anticonvulsants.
 45. The composition of claim 44, wherein said second agent is selected from a 5HT_(IB/ID) agonist, a 5HT_(ID) agonist, and a 5HT_(IF) agonist.
 46. The composition of claim 45, wherein said second agent is selected from rizatriptan, sumatriptan, naratriptan, zolmitriptan, almotriptan, eletriptan, avitriptan, frovatriptan, LY334370 and PNU-142633.
 47. The composition of claim 44, wherein said second agent is selected from ergotamine and dihydroergotamine.
 48. The composition of claim 44, wherein said second agent is aspirin or acetaminophen.
 49. The composition of claim 44, wherein said second agent is a glucocorticoid.
 50. The composition of claim 44, wherein said second agent is a non-steroidal anti-inflammatory agent.
 51. The composition of claim 50, wherein said second agent is selected from ibuprofen, ketoprofen, fenoprofen, naproxen, indomethacin, sulindac, meloxicam, piroxicam, tenoxicam, lornoxicam, ketorolac, etodolac, mefenamic acid, meclofenamic acid, flufenamic acid, tolfenamic acid, diclofenac, oxaprozin, apazone, nimesulide, nabumetone, tenidap, etanercept, tolmetin, phenylbutazone, oxyphenbutazone, diflunisal, salsalate, olsalazine and sulfasalazine.
 52. The composition of claim 44, wherein said second agent is an anticonvulsant selected from topiramate, zonisamide, divalproex sodium, pregabalin, gabapentin, levetiracetam, lamotrigine and tiagabine.
 53. A pharmaceutical composition comprising: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from angiotensin II antagonists, angiotensin I antagonists, angiotensin converting enzyme inhibitors, and renin inhibitors.
 54. The composition of claim 53, wherein said second agent is selected from losartan, candesartan, candesartan cilexetil, irbesartan, valsartan, eprosartan, telmisartan, olmesartan, medoxomil, captopril, benazepril, quinapril, perindopril, ramipril, trandolapril, lisinopril, and enalapril.
 55. A pharmaceutical composition comprising: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from anti-anxiety agents and neuroleptics.
 56. The composition of claim 55, wherein said second agent is selected from, diazepam, alprazolam, chlordiazepoxide, olanzapine, droperidol, prochlorperazine, chlorpromazine and quetiapine.
 57. A pharmaceutical composition comprising: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from beta-blockers and calcium channel blockers.
 58. The composition of claim 57, wherein said second agent is selected from timolol, propanolol, atenolol, metoprolol, nadolol, flunarizine, diltiazem, amlodipine, felodipine, nisolipine, isradipine, nimodipine, lomerizine, verapamil, nifedipine, prochlorperazine and civamide.
 59. A pharmaceutical composition comprising: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from anti-depressants, selective serotonin reuptake inhibitors, and NE reuptake inhibitors.
 60. The composition of claim 59, wherein said second agent is selected from amitriptyline, nortriptyline, clomipramine, imipramine, venlafaxine, doxepin, protriptyline, desipramine, trimipramine, fluoxetine, paroxetine, sertraline, duloxetine, escitalopram, and citalopram.
 61. A pharmaceutical composition comprising: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from botulinum toxins A or B.
 62. A pharmaceutical composition comprising: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from vanilloid receptor antagonists, adenosine 1 antagonists, NR2B antagonists, substance P antagonists, granzyme B inhibitors, endothelin antagonists, norepinephrin precursors, nitric oxide synthase inhibitors, neuroleptics, bradykinin antagonists, gap junction inhibitors, AMPA/KA antagonists, sigma receptor agonists, chloride channel enhancers, monoamine oxidase inhibitors, opioid agonists, and leukotriene receptor antagonists.
 63. The composition of claim 62, wherein said second agent is selected from montelukast and zafirlukast.
 64. The composition of claim 62, wherein said second agent is aprepitant.
 65. A pharmaceutical composition comprising: a therapeutically effective amount of the compound of claim 1 or a pharmaceutically acceptable salt thereof; and a therapeutically effective amount of a second agent selected from the group consisting of anti-emetics, prokinetics, and histamine H1 antagonists. 